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RaFael FajardoCALIF ORNIA �. STATEMENT OF ECONOMIC INTERESTS " " "�"" FAIR POLITICAL PRACTICES COMMISSION I COVER PAGE MAR 1 7 2009 Please t or print in ink. A Public Document CITY CLERK'S OFFICE RV NAME (LAST) (FIRST) (MIDDLE) UAV.Wlt, EftEP 01E ft, Fajardo Rafael Martin ( 626 ) 569 -2151 MAILING ADDRESS STREET CITY STATE ZIP CODE OPTIONAL: FAX / E -MAIL ADDRESS (May use business address) P.O. Box 850 West Covina CA 91793 1 . Office, Agency, or Court Name of Office, Agency, or Court: City of Rosemead Division, Board, District, if applicable: Your Position: Associate Civil Engineer P. If filing for multiple positions, list additional agency(ies)/ position(s): (Attach a separate sheet if necessary.) Agency: Position: 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ County of X City Of QdS6f{ oA0 ❑ Multi- County ❑ Other Type of Statement (Check at least one box) 4. Schedule Summary I. Total number of pages 1 including this cover page: ► Check applicable schedules or "No reportable interests." 1 have disclosed interests on one or more of the attached schedules: Schedule A -1 ❑ Yes - schedule attached Investments (Less than 10% Ownership) Schedule A -2 ❑ Yes - schedule attached Investments (10% or greater Ownership) Schedule B ❑ Yes - schedule attached Real Property Schedule C ❑ Yes - schedule attached Income, Loans, & Business Positions f1mome other than Gifts and Travel Payments) Schedule D ❑ Yes - schedule attached Income - Gifts Schedule E ❑ Yes - schedule attached Income - Gifts - Travel Payments -or- ® No reportable interests on any schedule ❑ Assuming Office /Initial Date: —J © Annual: The period covered is January 1, 2008, through December 31, 2008. -or- 0 The period covered is through December 31, 2008. ❑ Leaving Office Date Left: (Check one) O The period covered is January 1, 2008, through the date of leaving office. -or- 0 The period covered is through the date of leaving office. ❑ Candidate Election Year: 5. Verification I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the information contained herein and in any attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date Signed V3 /l g (month, day, year) Signature e the originally signed statement with your filing o fe-w FPPC Form 700 (2008/2009) FPPC Toll -Free Helpline: 866 /ASK -FPPC www.fppc.ca.gov