Brandon MatsdorfDate Received
STATEMENT OF ECONOMIC INTERE �L rIVLZD Use Only
CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION COVER PAGE CITY OF ROSEMEAD
MAR 2 5 2003
Please type or print in ink A Public Document - -
NAME (LAST)
(FIRST) -
(MIDDLE)
NUMBER
MAILING ADDRESS _ STREET _ CITY ZIP CODE OPTIONAL' FAX r E -MAIL ADDRESS
(May be business address)
N . W i 1 ca CZ�ernad I�
1 . Office, Agency or Court
Names
1 Y �mW�1�1�1
Division, board, District, if applicable:
Comm \SS1 onelr
Position:
�+ 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
City of V A
❑ Multi- County
❑ Other
3. Type of Statement (Check at least one box)
❑ Assuming Office /Initial Date:__J___J_
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: —J �—
(Check one) -
• The period covered is January 1, 2002, through
the date of leaving office.
-or-
O 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 ro% ownership)
Schedule A -2 ❑ Yes- schedule attached
Investments jtor orgreaiar Oahmahip)
Schedule B ❑ Yes - schedule attached
Real Property
Schedule C ❑ Yes - schedule attached
Income & Business Positions (income other than roans, Gills, and Travel)
Schedule D ❑ Yes - schedule attached
Income - Loans
Schedule E Yes - schedule attached
Income - Gifts
Schedule F ❑ Yes - schedule attached
Income - Travel Payments
-or-
r ❑ No reportable interests on any schedule
Total number of ages completed including this
cover page: `E-
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.
I r
Date Signed
Signature
your
FPPC Form 700 (2002/2003)
FPPC Toll -Free Helpline: 866 /ASK -FPPC
SCHEDULE E
Income — Gifts
> NAME OF SOURCE
A
X\ cah waN-
Gi'eVLA
ADDRESS
N ber - FullerAcr� CA
-SS
BUSINESS ACTIVITY, IF ANY, OF SOURCE
�'2
I
li y - OA3M, - Pyu/ G
DESCRIPTION OF GIFT(S)
DESCRIPTION OF GIFT(S) VIA,LLU-1E
DATE
/p —
$
S)0Y- \ �
j - ;3j O2-
� /
a /
3 / l?2 .
$
-jj
$
--J --J—
> NAME OF SOURCE
-
ADDRESS
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DESCRIPTION OF GIFT(S) VALUE
DATE
$
$
—/
$
--J --J—
>- NAME OF SOURCE
ADDRESS
BUSINESS ACTIVITY, IF ANY,_ OF SOURCE
DESCRIPTION OF GIFT(S) VALUE
DATE
$
ADDRESS
$
--J --J—
Comments:
> NAME OF SOURCE
_.
ADDRESS
BUSINESS ACTIVITY, IF ANY,
OF SOURCE
DESCRIPTION OF GIFT(S)
VALUE
DATE
$
> NAME OF SOURCE
ADDRESS
BUSINESS ACTIVITY, IF ANY,
OF SOURCE
DESCRIPTION OF GIFT(S)
VALUE
DATE
> NAME OF SOURCE
ADDRESS
BUSINESS ACTIVITY, IF ANY,
OF SOURCE
DESCRIPTION OF GIFT(S)
VALUE
DATE
$
FPPC Form 700 (2002/2003) Sch. E
FPPC Toll -Free Helpline: 866 /ASK -FPPC