Donald WagnerSTATEMENT OF ECONOMIC INTERESE(:
CITY OF ROSE NNN��ICCA
COVER PAGE
A Public Document
MAR 2'; 2003
1 . Office, Agency or Court
Name:
Ctv OF 7F;rJ_LI t,e9d
Division, Board, District, if applicable:
Position: -
A54tS - cat/
�+ If filing for multiple positons, list additio agency(ies)/
position(s): (Attach a separate sheet if necessary.)
Agency:
Position: "
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ County of
VCity of &xld !
❑ Multi- County
❑ Other
3. Type of Statement (Check at least one box)
❑ Assuming Office /Initial Date: —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: ��—
(Check one)
O The period covered is January 1, 2002, through
the date of leaving office.
-or-
0 The period covered is _ /_J, 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% ownersinp)
Schedule A -2 ❑ Yes – schedule attached
Investments fto% or greater ownership)
Schedule B ❑ Yes – schedule attached
Real Property
Schedule C ❑ Yes – schedule attached
Income & Business Positions pncome other than Loans, ems, and rrevap
Schedule D ❑ Yes - schedule attached
Income – Loans
Schedule E _ �71'Yes – schedule attached
Income –Gifts f�
Schedule F ❑ Yes – schedule attached
Income – Travel Payments
-or-
r ❑ No reportable interests on any schedule
Total number of pages completed including this
cover page:
5. Verification
I have used all reasonable diligence in preparing this
statement. 1 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
on y, year)
Signature' 3
(File the originally signed stale nl with your filing official.)
FPPC Form 700 (200212003)
FPPC Toll -Free Helpline: 666 /ASK -FPPC
, , OFFICE
NAME (LAST)
(FIRST)
(MIDDLE) - r
DAYTIME TELEPHONE NUMBER -
tt71v
V .
- ' 102
MAILING ADDRESS
STREET _ CITY
ZIP. CODE
OPTIONAL: FAX / E -MAIL ADDRESS
(May be business address)
3
t
Y � Z7a
1 . Office, Agency or Court
Name:
Ctv OF 7F;rJ_LI t,e9d
Division, Board, District, if applicable:
Position: -
A54tS - cat/
�+ If filing for multiple positons, list additio agency(ies)/
position(s): (Attach a separate sheet if necessary.)
Agency:
Position: "
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ County of
VCity of &xld !
❑ Multi- County
❑ Other
3. Type of Statement (Check at least one box)
❑ Assuming Office /Initial Date: —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: ��—
(Check one)
O The period covered is January 1, 2002, through
the date of leaving office.
-or-
0 The period covered is _ /_J, 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% ownersinp)
Schedule A -2 ❑ Yes – schedule attached
Investments fto% or greater ownership)
Schedule B ❑ Yes – schedule attached
Real Property
Schedule C ❑ Yes – schedule attached
Income & Business Positions pncome other than Loans, ems, and rrevap
Schedule D ❑ Yes - schedule attached
Income – Loans
Schedule E _ �71'Yes – schedule attached
Income –Gifts f�
Schedule F ❑ Yes – schedule attached
Income – Travel Payments
-or-
r ❑ No reportable interests on any schedule
Total number of pages completed including this
cover page:
5. Verification
I have used all reasonable diligence in preparing this
statement. 1 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
on y, year)
Signature' 3
(File the originally signed stale nl with your filing official.)
FPPC Form 700 (200212003)
FPPC Toll -Free Helpline: 666 /ASK -FPPC
SCHEDULE E
Income — Gifts
> NAME OF SOURCE
�Wul G�1,�CSMAN
ADDRESS
Am 07M 4 'u os) s,�
BUSINESS ACTIVITY, IF ANY, OF SOURCE
t Aa fi
DESCRIPTION OF GIFT(S) VALUE DATE
wru $
$
��—
> NAME
1 O ' F SOURCE /�.
Wj S
�RESS
wn cyOzy Vvwv
J%_AA �
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DESCRIPTION OF GIFT(S) VALUE
DATE
DATE
�JyO�
V�. ft A (
$�
�(,
V,Y�1
$
✓`I� 100
BUSINESS ACTIVITY, IF ANY, OF SOURCE
k�) Cw, t, cA
> NAM OF SOURCE
�
„1, T ��
ADDRESS
1 00 N
3a r(amQ
✓`I� 100
BUSINESS ACTIVITY, IF ANY, OF SOURCE
k�) Cw, t, cA
WNJ -1600
DESCRIPTION OF GIFT(S)
VALUE DATE
$ Z -- 111L 17-
$ __J ---
Comments:
NAME OF SOURCE - -
fl1rvLc,k
ADDRESS
777 r �alra &A— 31" Ste, 3 20v
BUSINESS ACTIVIT?If�NY, OF SOURCE
Los '1`A ca gooa7- 595Y
DE5CRIPTI F GIFT(S) VALUE - DATE
Nxk tck etc $
34o
%
> NAME OF SOURCE
ADDRESS
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DESCRIPTION OF GIFT(S) VALUE DATE
$ � __J—
$ __J __J_
> 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: 666 /ASK -FPPC