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Jerry MotaC.1J Y "I' Kl�7L +iVSr.tu STATEMENT OF ECONOMIC INTERES S Date Received MA Qfflcidl !/se Q1 Please type or print in ink. COVER PAGE CITY CLERIC'S OFI BY_____.— v..—.r A Public Document NAME (LAST) (FIRST) (MIDDLE) DAYTIME TELEPHONE NUMBER Mota Gerardo Arturo ( 626 ) 569 -2265 MAILING ADDRESS STREET CITY STATE ZIP CODE OPTIONAL: FAX / E- MAILADDRESS (May use business address) 8838 E. Valley Blvd. Rosemead CA 91770 gmota @cityofrosemead.org 1 . Office, Agency, or Court Name of Office, Agency, or Court: City of Rosemead Division, Board, District, if applicable: Parks and Recreation Your Position: Recreation Supervisor ► 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 ® City of Rosemead ❑ Multi- County ❑ Other Type of Statement (Check at least one box) ❑ Assuming Office /Initial Date: ® 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 Ye 4. Schedule Summary ► Total number of pages 1 including this cover page: — ► Check applicable schedules or "No reportable interests." I have disclosed interests on one or more of the attached schedules: Schedule A -1 ❑ Yes – schedule attached Investments (Less than to %Ownershipl Schedule A -2 ❑ Yes – schedule attached Investments (10% or greater owncrsnlp) Schedule B ❑ Yes – schedule attached Real Property Schedule C ❑ Yes – schedule attached Income, Loans, & Business Positions (h,come Omer than Gins earl 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. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date Signed 03/30/2009 (month, day, � year) .`'j/ /7 Signatu a �"'"" _ �e orifainally signed statement with your filing official.) FPPC Form 700 (2008/2009) FPPC Toll -Free Helpline: 866 /ASK -FPPC www.fppe.ca.gov