2003 (12)CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
Please type or print in ink
(LAST)
STATEMENT OF ECONOMIC
COVER PAGE
A Public Document
(FIRST) I (MIDDLE)
CITY
1 . Office, Agency or Court
Name of Office, Agency or Court:
C/ I
C-OU A) C Q-
Division, Board, District, if applicable:
A i - / AI(E c/Te 0 F PyS6me
Your Position:
)OCR e�_ OF . 7W c /may eIadc-tL
.. If filing for multiple positions, list additional agency(ies)/
posilion(s):. (Attach a separate sheet if necessary.)
Agency:
Position:
2. Jurisdiction of Office (check at /east one box)
❑ State
❑ County of
[K C ty of — Boleyn C&D,
❑ Multi- County
❑ Other
3. Type of Statement (Check at least one box)
M' Assuming .Office /Initial Date: _J---J—
[5Annuat: The period covered is January 1, 2003,
through December 31, 2003.
-or-
0 The period covered is through
December 31, 2003.
❑ Leaving Office Date Left: __J ___J—
(Check one)
0 The period covered is January 1, 2003, through
the dale of leaving office.
-or-
0 The period covered is through
the date of leaving office.
❑ Candidate
STATE ZIP CODE
o. Box 399
®CC C ceived
CITY OF ROSEMEAD
NJAR 1 2004
( ) 46 -Gl7S
OPTIONAL: FAX I E -MAIL ADDRESS
4. Schedule Summary
(Check applicable schedules or "No reportable interests.')
r During the reporting period, did you have any reportable
interests to disclose on:
Schedule A -1 ❑ Yes - schedule attached
investments (mss man 10 0w mip)
Schedule A -2
- ❑ Yes - schedule .attached
Investments po% v greater GwwsM'p)
Schedule B
❑ Yes - schedule attached
Real Property
-
Schedule C
❑ Yes - schedule attached
Income 8 Business Positions rvm ebmermm mans, Gins, and Tme )
Schedule D
❑ Yes - schedule attached
Income - Loans
Schedule E
[Kes - schedule attached
Income - Gifts.
Schedule F ❑ Yes - schedule attached
Income - Travel Payments
-or-
E] No reportable interests on any schedule
Total number of pages
completed including this cover page: t GJD
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 F,56. Z� � o o
FPPd -- form 700 (2 00 312 00 4)
FPPC Toll -Free Helpline: 8661ASK - FPPC
SCHEDULE E
Income — Gifts
> NAME OF SOURCE� -
.YV W A)
ADDRESS
U -38 VAS ��Y b�LJ'�.F�Lss�ntcrh� /C
BUSINESS ACTIVITY, IF ANY, OF SOURCE
L /fjyHW.
DATE (mm/dd /yy) VALUE DESCRIPTION OF GIFT(S)
6v GIJ r�i�fE
J_J $
� J— $
> NAME OF SOURCE
ADDRESS
BUSINESS ACTIVITY, IF ANY. OF SOURCE
DATE (mrrJddlyy) VALUE DESCRIPTION OF GIFT(S)
/J- $ _
__j --- J_ $
$
>. NAME OF SOURCE -
ADDRESS - -
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd /yy) VALUE
—/_ $
$
DESCRIPTION OF GIFT(S)
Comments;
Name
Joe V/f
NAME OF SOURCE
ADDRESS - -
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mmldd /yy) VALUE DESCRIPTION OF GIFT(S)
$
��— S
> NAME OF SOURCE
ADDRESS
--
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE(mm /ddlyy)
VALUE DESCRIPTION OF GIFT(S)
J J—
$
��—
$
> NAME OF SOURCE
ADDRESS.
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd /yy) VALUE
$
$
DESCRIPTION OF GIFT(S)
FPPC Form 700 (2 0 0 312 00 4) Sch. E
FPPC Toll -Free Helpline: 666 /ASK -FPPC