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2003 (23)CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION COVER PAGE T$ - ® -- /� � C ete y -R 7 e i i � v_ed f K E\ s �I "La!Y . k CITY OF ROSEMEAD j FEB 2 4 2004 1 Please type or print in Ink A Public Document r NAME (LAST) (FIRST) (MIDDLE) - - __DA TIMETEl €PNpNE- NUMBER L.- Tirl� . L__ 31 4 p0 9 '�21 MAILING ADDRESS STREET (May be business address) CITY - STATE ZIP CODE OPTIONA . E -MAIL ADDRESS A - o•Z�(�Q ; 2 8'T - t S . - 5 1-45 - *_31 � S W-Pk K11a k11 CA, f'l, 3l0 4A 14 n c OSOSo 1 . Office, Agency or Court Name of Office, Agency or Court: Division, Board, District, if applicable: Your Position: 11 fFlY /CgA y f& hzzg&l f /y If filing for multiple positions, list additional agency(ies)l position(s (Attach a separate sheet if __necessary.) Agency: d1d7 WligA®/AlaF� AI., t 1, .' I— Position: � ll1✓(J1 (_ Nyb_L 2. Jurisdiction of Office (check at feast one box) ❑ State ❑ County of ArInity of P r) CI I. A ry 1 ❑ Multi -County ❑ Other Type of Statement (Check at least one box) ❑ Assuming Office /Initial Date:---j --- J_ NAnnual: 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: __j _1_ (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. ❑ Candida STATEMENT OF ECONOMIC 4. Schedule Summary (Check applicable schedules or "No reportable Interests. n) • During the reporting period, did you have any reportable interests to disclose on: Schedule A -1 ;R<es - schedule attached Investments tress man toss ow hb) Schedule A -2 as - schedule attached Investments (f0 % or greater Ownership) Schedule B ❑ Yes - schedule attached Real Property Schedule C ❑ Yes - schedule attached Income 8 Business Positions pncome ogre, man ro, ctrl= am Trevep Schedule D ❑ Yes - schedule attached Income - Loans Schedule E ❑ Yes - schedule attached Income - Gifts Schedule F ❑ Yes - schedule attached Income - Travel Payments -or- er ❑ No reportable interests on any schedule Total number of pages L� 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 0 o th ,ye Signature Q A K - (File r,ginally signed statement With your Ming official.) SCHEDULE A -1 Investments Stocks, Bonds, and Other Interests (Ownership Interest is Less Than 10%) Do not attach brokerage or financial statements. NAME OF BUSINESS ENTITY ss� e�a�0 GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $io,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED > NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) IF APPLICABLE, LIST DATE: J_/ 03 J_/ 03 ACQUIRED DISPOSED > NAME OF BUSINESS ENTITY . GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,1101 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) IF APPLICABLE, LIST DATE: 03 ACQUIRED DISPOSED Comments: CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION WWO > NAME. OF BUSINESS ENTRY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $100,001 - $i,muco NATURE OF INVESTMENT ❑ Stock ❑ $10,001 - $100,000 ❑ Over $1,000,000 ❑ Other ( Descnbe) IF APPLICABLE, LIST DATE: J _j 03 ACQUIRED DISPOSED > NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $100,001 - $1,000,00o NATURE OF INVESTMENT ❑ Stock ❑ $10,001 - $100,0oo ❑ Over $1,000,000 ❑ Other (Oescnbe) IF APPLICABLE, LIST DATE 03 ACQUIRED DISPOSED > NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 - NATURE OF INVESTMENT ❑ Stock ❑ Other ( Descnbe) IF APPLICABLE, LIST DATE: _J_/ 03 __/_J ACQUIRED DISPOSED FPPC Form 700 (200312004) Sch. A -1 FPPC Toll -Free Helpllne: 8661ASK -FPPC Y O O r EA J x Y O O x O O 7 (p N Y Y �o m r N x x x x x x x x x x x x x x x x � 6% (0 LL Cl) Cl) Cl) O CO 00 O O O O N () N N N ti C) C 2O W 1 'IT o a O 00 O O O W O O) OO Nr N NNN N OONM Cl) (M M(+)M I- -0 (3) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 O) (3) 0 0 0 0 0 0 0 0 0 0 N 0 0 0 0 0 � r N N N N N N N N N N N N N N N N � � r 7 Cl) C*4 (�(�(O i-X 000000 f. M 0) '75 O' N N Orr O r 00 O M r N r Or C:) r Q < OD N (� r r M (� ( co \ r (O 0�0 (A O O O r O O r r 0 0 0 r O (D r 0 0 0 N 'O t C O L LL Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y U U U U U U U U U U U U U U U U U l0 0000000 O O O O O O O O O O E U Z N N tll N N V q N N Ul N Ul N g N N N O N m Q' Vl Y U O r E a � °7 0 - o a U 0) O 2 D N o Q — Cl) Uw w _ Q u N O EU) LL< ~ c a) H ?� Q .� Q ur ` O _ _ O M od LJ QUO o a) �2U 'NON 5: N 0 a E w N J N - U O U c � j' CO CO J c C� N a 5 U m m o m Z o N o `m E o w a 6 c 3 I- o) c U) c X c a Q CD NIL ca arc in��a�c� >a >a�c�cia SCHEDULE A -2 CALIFORNIA FORm 7 Investments, Income, and Assets FAIR POLITICAL PRACTICES COMIASSION of Business Entities /Trusts Name n r` (Ownership Interest is 10% or Greater) 'F{—(L L �Q v W tl,f .L A293 �VG A.1 7 kQA Al Noma 1 � Address 40�Frr�. Check one 7 ❑ Trust go to 2 11 Business Entity. comn late the box, then oo to 2 GENERAL DESCRIPTION OF BUSINESS ACTIVITY EAR MARKET VALUE IF APPLICABLE, LIST DATE: 2,000 - $10,000 ❑ $10,001 - $100,00o J 03 JJ 03 ❑ $100,001 - $1,000,000 ACQUIRE DISPOSED ❑ Over $1,000,000 ' NATURE OF INVESTMENT - ❑SolePmprietorship CR1 ❑ _ ONer YOUR BUSINESS POSITION ❑ $0-$499 ❑ $10,001 - $10%000 ❑$500 - $1,000 i�VER$100,000 ❑ $1,001 - $10,000 - Check one box: ❑ INVESTMENT ❑ REAL PROPERTY NOALl-� Name of Business Entity pL Street Address or Assessor's Parcel Number of Real Property Description of Business Activity Dr FAIR MARKET VALUE City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 ❑ $100,001 - $1,000,000 ❑ $to,00l - $1o0,000 J 03 — j___/ _ L3 _ ❑ $100,00l - $1,000,000 ACQUIRED DISPOSED ❑ over $1,000,000 ❑ Property - Ownership /Deed of Trost NATURE OF INTEREST ❑ Properly Ownership /Deed of Trust ❑ Stock ❑ Partnership ❑ Trust go to 2 ❑ Business Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 J 03 ,JJ 03 ❑ $too Doi - $1 000 Goo ACQUIRED DISPOSED ❑ over $1,0oo,ouo NATURE OF INVESTMENT E] Sole Proprietorship ❑ Partnership YOUR BUSINESS POSITION ❑ Clore ❑ $0 - $499 ❑ $10,001 - $100,000 0 $500 - $1,000 OVER $1100,000 ❑ $1,001 - $10,000 Check one box: ❑ INVESTMENT ❑ REAL PROPERTY ,...,r " Street Address or Assessors Parcel Number of Real Property City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 - ❑ $1o,o01 - $1o0,000 JJ JJ 03 ❑ $100,001 - $1,000,000 ACQUIRED DISPOSED ❑ over $1,000,00o NATURE OF INTEREST ❑ Property - Ownership /Deed of Trost ❑ Stock ❑ Partnership ❑ Leasehold E] Other I ❑ Leasehold [3 Other Y - — 1.1.9 Yis. remaining ❑ Check lox If additional schedules reporting investments or real property ❑ Check box if additional schedules reporting investments or real property are a6achad are a0ached a Comments: FPPC Form 700 (200312004) Sch. A -2 FPPC Toll -Free Helpline: 866 /ASK -FPPC