Duc LoiSTATEMENT OF ECONOMIC
Please type or print in ink
COVER PAGE
A Public Document
` a � te d;, � � R I � eceived
_ CE I y -
CITY OF ROSEMEAD i
MAR 16' 2004
NAME (LAST) (FIRST) (MIDDLE) )' V I r _I FDA Li0A4E- NUMBER
/-C, i' 0 a zf'p- iJ jz
MAILING ADDRESS STREET CITY STATE ZIP CODE OPTIONAL: FAX I E-MAIL ADDRESS
(May be business address)
7 6 Zr/ l Z�2So PLA cr— (laS" "P `�1`770 ,
1 . Office, Agency or Court
Name of Office, Agency or Court:
Division, Board, District, if applicable: ,
Your Position:
�+ 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)
❑ Stale
❑ County of n ,,
[X City of -
❑ Multi -County _
❑ Other
3. Type of Statement (Check at least one box)
❑ Assuming Office /Initial Date: __
Ix through The period covered is January 1, 2003,
through December 31, 2003.
-or-
0 The period covered is through
December 31, 2003.
❑ Leaving Office Dale Left: —J_J
(Check one)
0 The period covered is January 1, 2003, through
the date of leaving office.
-or-
0 The period covered is through
the date of leaving office.
❑ Candidate
4. Schedule Summary
(Check applicable schedules or 'We reportable Interests.")
During the reporting period, did you have any reportable
interests to disclose on:
Schedule A -1 E) Yes - schedule attached
Investments (Cass a,an'10% ownership)
Schedule A -2 F1 Yes — schedule attached
investments(fo% wgramde ownership) -
Schedule .B ❑. Yes . - schedule attached
Real Property -
Schedule C ❑. Yes - schedule attached
Income 8 Business Positions (Income - other man Loans, Gins, and nova)
Schedule D E] Yes - schedule attached
Income - Loans
Schedule E ❑ Yes - schedule attached
Income - Gilts -
Schedule F - ❑ Yes - schedule attached
Income - Travel Payments
-o r-
.. Z eportable interests on any schedule
Total number of pages /
completed including this cover page:
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
(month, Y. Year ,
Signature 4..
(File e: originally signed statement wgh your gling official)
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