2003 (24)STATEMENT OF ECONOMIC INTERESTS RE C- Date u Req_eivea
a ys¢jgnly .
COVER PAGE CITY OF ROSEMEAD
Please type or print in Ink A Public Document
MAR 2 2004
NAME (LAST) (FIRST) (I IT
STREET CITY ZIP CODE OPTIONAL: FAX E -MAIL ADDRESS
E V / L L B' - I;PLV 4 ) ef&aiW R 17 7
1. Office, Agency or Court
Name of Office, Agency °"i ourt:
V 0 P m exi
Division, B ard, District, if applicable:
Your Position
A s + If filing for multiple positions, list additional a cy(ies)/
position(s): (Attach a separate sheet if nece ry.)
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
❑ State
n County of ! y
City ofd u
❑ Multi- County
❑ Other
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 (Less Nan io% Ownership)
Schedule A -2 ❑ Yes - schedule attached
Investments (io% or greater owneahip)
Schedule B ❑ Yes - schedule attached
Real Property
Schedule C ❑ Yes - schedule attached
Income & Business Positions (Ncome other Nan Loans, Gins, ano, Try )
Schedule D ❑ Yes - schedule attached
Income - Loans
Schedule E Yes - schedule attached
Income - Gilts V y
Schedule F ❑ Yes - schedule attached
Income - Travel Payments
-or-
.. ❑ No reportable interests on any schedule -
Total number of pages
completed including this cover page:
❑ Assuming Office /Initial Date: ��—
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 Dale Left:
(Check one)
0 The period covered is January 1, 2003, through
the date of leaving office.
-or-
0 The period covered is I I through
the dale 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 under the laws of the State
of California that the foregoing is true and correct.
Date Signed
Zid [h, day, year)
Signature
(File the orig statement with your filing official.)
FPPC Form 700 (200312004)
FPPC Toll -Free Helpline: 866/ASK-FPPC
SCHEDULE E
Income — Gifts
> NAME OF
> NAME OF SOURCE
e5 s2E�sM�J
ADDRESS
1
IF ANY, OF SOURCE BUSINESS ACTIVITY, IF ANY, OF SOURCE
A
DATE (mm/dd /yy)
VALUE
JJ_
$
JJ
$
$
JJ
s
> NAME OF SOURCE
GIFT(S)
ADDRESS
2 M
BUSINESS ACTIVI / �T IF ANOF K-Rn
. •1L � {DDAAATTTEE J E (• wLm'f��,mldddd/ /yy) VALUE DESCRIPTIO OF GIFT(S)
JJ_ $
JJ— s
RDDRE S
90 ],avr - 10
BUSINESS ACTIVITY IF V OF SOURCE
ATE (mm /dd /y /yy VALUE DESCRIPTION OF GIFT(S)
JJ $
JJ_ $
Comments:
DATE (mm/dd /yy)
VALUE
JJ_
$
BUSINESS ACTIVITY, IF ANY, OF SOURCE
JJ_
$
JJ
$
$
$
DESCRIPTION OF GIFT(S)
> NAME OF SOURCE
ADDRESS
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd /yy)
VALUE DESCRIPTION OF GIFT(S)
JJ
$
JJ
$
JJ_
a
> NAME OF SOURCE
ADDRESS
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd /yy)
VALUE DESCRIPTION OF GIFT(S)
J
$
JJ—
$
JJ—
$
FPPC Form 700 (200312004) Sch. E
FPPC Toll -Free Helpline: e661ASK -FPPC