2003 (34)STATEMENT OF ECONOMIC INTERESTS Date Received
orriom use only
COVER PAGE RECEIVE, L
1 CITY OF ROSEMEAD
Please type or print In ink A Public Document MAR 2 5 2004
NAME (LAST) (FIRST
� I- `` I � o � (MIDD
UlAl ?,q N r L � f
MAILING ADDRESS STREET CITY - STATE ZIP CODE OPTIONAL: FAX I E -MAIL ADDRESS
(May be business address)
1 K 3 S if 9 r � ; ro
1 . Office, Agency or Court
Name of Office, Agency or Court:
�R rA - f=ry C �cMMrSS /�
Division, Board, District, if applicable:
AIrA--
Your Position:
YA A-GFi C
If filing for multiple positions, list additional agency(ies)/
position(s): (At tach a separate sheet if necessary.)
Agency: 1 / 4
Position:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑� ,a County of
w J �a-
tyof �g gym t�1 �
❑ Multi- County
❑ Other
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 - ❑Yes - schedule attached
Investments. (Less than to% ownership)
Schedule A -2 ❑ Yes - schedule attached
Investments (ta% e,grealer ownerunp)
Schedule B ❑ Yes - schedule attached
Real Property
Schedule C ❑ Yes - schedule attached
Income & Business Positions pncomt other man Loans. Gigs, and never)
Schedule D ❑ Yes - schedule attached
Income - Loans
Schedule E ❑ Yes - schedule attached
Income- Gifts
Schedule F ❑ Yes - schedule attached
Income - Travel Payments
-or-
reportable interests on any schedule
Total number of pages - -
completed including this cover page:
❑ Assumi Office /Initial Date: J am—
nnuml: 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
(Check one)
O The period covered is January 1, 2003, through
the date of leaving office.
-or-
0 The period covered is through
the date of leaving office.
❑ Candidate
5. Verification
1 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 H 1
(mp h a year)
Signature
(File the originally signed statement with your fling official.)
FPPC Form 700 (2 0 0 3120 0 4)
FPPC Toll -Free Helpllne: 8661ASK.FPPC