Donald WagnerSTATEMENT OF ECONOMIC INTERES S Date Received
CALIFORNIA FORm 700 ��k. V.aV EVi Use on,
FAIR POLITICAL PRACnCES COMMISSION A Public Docuinent CITY OF ROSEMEAD
Please type or print in ink
COVER PAGE MAR 26 2002
NAME (LAST) (FIRST) (MIDDLE) `1'7'x/ t1i. BRIM a7 LIT' IE NUMBER
S ( )S69 i o
MAILING ADDRESS STREET CITY ZIP CODE OPTIONAL: FAX I E -MAIL ADDRESS
(May b business address) ALItY 0qd 917VO
1. Full Name of Office Sought or Held,
Agency or Court: /
G,t, Oq ?OSP.�1�1e&_
Division, Boar , District, if applicable:
Position:
j N�w�aa�ey
�+ If filing for multiple po lions, list additio agency(ies)/
position(s): (Attach a separate sheet if necessary.)
Agency:
Position Title:
2. Jurisdiction of Office (Cheek one box)
❑ State
❑ County of
�P(City of ?� Me Q-
/1�
- /❑ Multi- County
❑ Other
3. Type of Statement (Check at least one box)
❑ Assuming Office /Initial Date: —l am_
Annual: The period covered is January 1, 2001,
through December 31, 2001.
-or-
0 The period covered is __J __J—, through
December 31. 2001.
❑ Leaving Office Date Left:
(Check one)
O The period covered is January 1, 2001, through
the date of leaving office.
-or-
0 The period covered is __J__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 hose Ownership) -
Schedule A -2 ❑ Yes :- schedule attached
Investments (Greater than ro,o. Ownership) -
Schedule B ❑,Yes - schedule attached -
Real Property
Schedule C ❑Yes.- schedule attached
Income 8 Business Positions (Income Other than Loans, Gars, and Traver)
Schedule D ❑ Yes - schedule attached
Income - Loans -
Schedule E KYes - schedule attached
Income - Gilts
Schedule F ❑ Yes schedule attached
Income - Travel Payments
-or-
❑ No reportable interests on any schedule
Total number of pages completed including this
cover page: Z,
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. n
Date Signed ma i t /�A l � � 1 r " O 2__
your
PPPC Form 700 (2001/2002)
Toll -Free Helpline: 866 /ASK -FPPC
SCHEDULE E
Income - Gifts
> NAME OF SOURCE
/JAW KJ rvz?s wI",i
A D o0sa��
4"1 jq
BUSINESS ACTIVITY, IF ANY, OF SOURCE
— LAW Pi 014
- DESCRIPTION OF GIFT(S) VALUE DATE
$ _ �-
$ ��-
>. i AM€�'F ply CE ��W��'t7 -
N A 1�DIRES11YSl.A�1.�, .RM- a
BUSINESS ACTIVITY, IF ANY, OF SOURCE - I
DESCRIPTION OF GIFT(S) VALUE - DATE
$
> NAME OF SOURCE
ADDRESS
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DESCRIPTION OF GIFT(S)
Comments:
VALUE DATE
$ __j—/
$ — / —/—
$ __j—/
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
$ __j 1-
> NAME OF SOURCE -
ADDRESS
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DESCRIPTION OF GIFT(S)
VALUE DATE
$
$ ��—
$ ��-
> NAME OF SOURCE
FPPC Form 700 (200112002) Sch. E
FPPC Toll -Free Helpline: 866 /ASK -FPPC