2003 (26)STATEMENT OF ECONOMIC
Please type or print in ink -
COVER PAGE
A Public Document
NAME (LAST) (FIRST) (MIDDLE) I ljI I M"rSE"llq tlOMBER
MAILING'ADDRESS STREET CITY STAIE ZIP - CODE OPTIONAL: FAX / E -MAIL ADDRESS
(May be business address) i
«y RJ D /'Se4fei+9
1 . Office, Agency or Court
Name of Office, Agency or Court:
Division, Board, District, if applicable:
Positio
^ A rm '
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)
❑ Stale
❑ County o
❑ City of
❑ Multi -County
❑ Other
Type of Statement (check at least one box)
❑ Assuming Office /Initial Date: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: _J __J
(Check one)
• The period covered is January 1, 2003, through
the date of leaving office.
-o r-
0 The period covered is __—]--J—, through
the dale of leaving office.
❑ Candidate
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 non io% owea sn,)
Schedule A -2 ❑ Yes - schedule attached
Investments (to% or greater owrre, pl
Date Received
/q �a ® el [ Usse OMy
CITY OF ROSEMEAD
MAR 2 2004
❑ Yes - schedule attached
Schedule C ❑ Yes - schedule attached
Income B Business Positions (tn.e one, non Loans, Gds, and Tnnet)
Schedule D ❑ Yes - schedule attached
Income - Loans -
Schedule E ❑ Yes - schedule attached
Income - Gifts
Schedule F ❑ Yes - schedule attached
Income - Travel Payments
-or-
e /-'
,70 No reportable interests on any schedule
Total number of pages .
completed including this cover page:
5. Verification
Ihave 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 `
your
FPPC Form 700 (200312004)
FPPC Toll -Free Helpline: 866 /ASK -FPPC