Kenneth RukavinaSTATEMENT OF ECONOMIC INTERES4 � _e elved
`
CITY OF ROS NAU
Please type or print in ink
COVER PAGE
A Puhlic Document
MAR 2:) 2003
E -
NAME (LAST) (FIRST) (MIDDLE) P AYTIME TE'� LEPHONE NUMBER
RUKAVINA KENNETH 562 908 -6200
MAILING ADDRESS STREET CITY ZIP CODE OPTIONAL' FAX / E -MAIL ADDRESS
(May be business address)
13191 CROSSROADS PKWY N. # 405 INDUSTRY 91746 krukavina @willdan.com
1 . Office, Agency or Court
Name:
CITY OF R
Division, Board, District, if applicable:
Position:
CONSULTANT
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
I] City of ROSEMEAD
❑ Multi- County
❑ Other
3. Type of Statement (Check at least one box)
❑ Assuming Office /Initial Date:
❑K Annual: The period covered is January 1, 2002,
through December 31, 2002.
.or-
0 The period covered is through
December 31, 2002.
❑ Leaving Office Date Left:
(Check one)
O The period covered is January 1, 2002, through
the date of leaving office-
-or-
0 The period covered is �� , through
the date 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 than to% oseen;ldp)
Schedule A -2 ❑ Yes — schedule attached
Investments (to% or greater ownership)
Schedule B ❑ Yes — schedule attached
Real Property
Schedule C ❑X Yes — schedule attached
Income & Business Positions (Irxnrne Other has Loess, Gifts, and T self
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
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 MARCH 18, 2003
(month, day, year)
Signature /
(File the originally signed statement with your fling official.)
FPPC Form 700 (200212003)
FPPC Toll -Free Helpline: 866 /ASK -FPPC
SCHEDULE C
Income & Business Positions
(Income Other than Loans, Gifts, and
Travel Payments)
> NAME OF SOURCE
KENNETH RUKAVINA
ADDRESS
13191 CROSSROADS PKWY N. #405 INDUSTRY
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
CONSULTANT
GROSS INCOME RECEIVED
❑ $500 - $1,000 ❑K $1.001 - $10.000
❑ $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
❑K 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
(Property, caq boat, etc.)
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
❑ Other
Comments:
Name
KENNETH RUKAVINA
> 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 $10,000 oriame
❑ 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
(Property, car, boat, etc.)
❑ Commission or ❑ Rental Income, list each source or 810,000 or more
❑ Other
FPPC Form 700 (200212003) Sch. C
FPPC Toll -Free Helpline: 866/ASK-FPPC