Kim BorisSTATEMENT OF ECONOMIC
Please type or print in ink.
(FIRST)
COVER PAGE
A Public Document
Palmer -Boris Kimberly L ( 909 ) 374 -5566
MAILING ADDRESS STREET CITY STATE ZIP CODE OPTIONAL: FAX I E -MAIL ADDRESS
(May use business address)
229 N. Palo Cedro Dr Diamond Bar Ca 91765 kboris(a)citvofrosemead.ora
1 . Office, Agency, or Court
Name of Office, Agency, or Court :
City of Rosemead
Division, Board, District, if applicable:
Parks & Recreation
Your Position:
Recreation Superviser
► If filing for multiple positions, list additional agency(ies)l
position(s): (Attach a separate sheet if necessary.)
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ County of
❑ city of Rosemead
❑ Multi- County
❑ Other
I Type of Statement (Check at least one box)
❑ Assuming Office/Initial Date: J �
❑ Annual: The period covered is January 1, 2008,
through December 31, 2008.
-or-
0 The period covered is -- lam, through
December 31, 2008.
❑ Leaving Office Date Left: --J --J —
(Check one)
O The period covered is January 1, 2008, through the
date of leaving office.
-or-
0 The period covered is J —J, through
the data of leaving office.
❑ Candidate Election Year:
4. Schedule Summary
► Total number of pages
including this cover page:
► Check applicable schedules or "No reportable
imeres[s."
I 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 rio% or Insurer ownership)
Schedule B ❑ Yes - schedule attached
Real Pmperty
Schedule C ❑ Yes - schedule attached
Income, Loans, & Business Positions Income omar man Gills
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
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.
1 certify under penalty of perjury under the laws of the State
of California that the foregoing is true and correct.
Date Signed March 26, 2009
(month, day, year)
Signature 1&'41
(File the originally signed statement with your filing official.)
FPPC Form 700 (200912009)
FPPC Toll -Free Helpline: 666IASK -FPPC www.fppc.ca.gov