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2003 (17)STATEMENT OF ECONOMIC INTERESTS R E � CALIF ORNIA • L ; CITY OF Rp� FAIR POLITICAL PRACTICES COMMISSION COVER PAGE F1 EAD MAR 22 2iu4 Please type or print in ink A Public Document NAME (LAST) (FIRST) (MIDDLE) " _EM-F r U B R GUERRA JAMES M 562 908 -6200 MAILING ADDRESS STREET CITY STATE ZIP CODE OPTIONAL: FAX I E -MAIL ADDRESS (May be business address) 13191 CROSSROADS PKWY N. #405 INDUSTRY CA 91746 jguerra @willdan.com 1 . Office, Agency or Court Name of Office, Agency or Court: CITY OF ROSEMEAD Division, Board, District, if applicable: - Your Position: CONSULTING BUILDING OFFICIAL • 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 F nthar 3. Type of Statement (Check at least one box) 4. Schedule Summary (Check applicable schedules or "No reportable interests.') • During the reporting period, did you have any reportable interests to disclose on: Schedule A -1 ❑ Yes - schedule attached Investments (Lass than to% oxnarship) Schedule A -2 ❑ Yes - schedule attached Investments po% orgmeter ownership) Schedule B ❑ Yes - schedule attached Real Property Schedule C © Yes - schedule attached Income & Business Positions (Tnaome other than Loans, Gins, and Tma ) Schedule D ❑ Yes - schedule attached Income - Loans Schedule E ❑ Yes - schedule attached Income - Gifts Schedule F ❑ Yes - schedule attached Income - Travel Payments -or- - ❑ No reportable interests on any schedule Total number of pages completed including this cover page: 2 ❑ Assuming Office /Initial Date:__J__J (] Annual: The period covered is January 1, 2003, through December 31, 2003. -or- 0 The period covered is __J__J, through December 31. 2003. ❑ Leaving Office Date Left: (Check one) • The period covered is January 1, 2003, through the date of leaving office. -or- O The period covered is ___/ --- J_, through the date of leaving office. ❑ Candidate 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 underthe laws of the State of California that the foregoing is true and correct. Date Signed MARCH 17, 20 (month, day, year) Signatur FPPC Form 700 (2 0 0312 0 04) FPPC Toll -Free Helpline: 8661ASK -FPPC SCHEDULE C Income & Business Positions (Income Other than Loans, Gifts, and Travel Payments) > NAME OF SOURCE JAMES M. GUERRA ADDRESS 13191 CROSSROADS PKWY N. #405 91746 BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION CONSULTING BUILDING OFFICIAL GROSS INCOME RECEIVED ❑ $500 - $1,000 © $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED © Salary ❑ Spouse's income ❑ Loan repayment ❑ Sale of (Property, car, boat, etc.) ❑ Commission or ❑ Rental Income, list each source of $10,000 or more ❑ Other (Describe) > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑ $1,001 - $10.000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's income ❑ Loan repayment ❑ Sale of ( Pmpery, car, boat, ek.J ❑ Commission or ❑ Rental Income, list each source of $10,000 or more ❑ Other (Describe) Comments: Name JAMES M. GUERRA > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's income ❑ Loan repayment ❑ Sale of ( Property, car, boat, etc) ❑ Commission or ❑ Rental Income, list each source of $10,wo or more ❑ Other (Describe) > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's income ❑ Loan repayment ❑ Sale or ( Pmperty, car, boat, etc.) ❑ Commission or ❑ Rental Income, list each source of $10,000 or more ❑ Other (Describe) FPPC Form 700 (200312004) Sch. C FPPC Toll -Free Helpline: 866/ASK-FPPC