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Holly KnappSTATEMENT OF ECONOMIC INTEgi , F ITGI�e RUCeoived A Public Document w✓ITY OF ROSEMEAD MAR 14 2002 De,. n...a nr non, m ink COVER PAGE NAME (LAST) (FIRST) (MIDDLE) n DAYTIME TELEPHONE NUMBER K4,N A-o-zp tLG LL �, ( a MAILING ADDRESS STREET CITY ZIP CODE OPTIONAL: FAX I E -MAIL ADDRESS (May be business address) S 36 - 7 � , q X71 1. Full Name of Office Sought or Held, Agency or Court: �_ . L' -- o f �S21M�(ne� Division, Board, Distr , if applicable: Po_ sition: I k-�-Cl c Q- oywrw'ss I Del ew - - -`if filing multiple positions, list additional agency(ies)/ " position(s): (Attach a separate sheet if necessary.) Agency: Position Title: 2. Jurisdiction of Office (Cheek one box) [] P County of /` 7 1-ity of < o VV\ ❑ 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, 2001, through December 31, 2001. -or 0 The period covered is —J� through December 31, 2001. ❑ Leaving Office Date Left: ��— (Check one) 0 The period covered is January 1, 2001, 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 nos ownersr e) Schedule A -2 Yes - schedule attached Investments (crease. an io% owoerchm) Schedule B - ❑ Yes - schedule attached Real Property Schedule C ❑ Yes - schedule attached Income & Business Positions (income Omer man Lonna, Gifts, 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 pages completed including this cover page: 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 Si g ned nlh, tlay� /0 � Signature FPPC Form 700 (2001/2002) FPPC Toll -Free Helpline: 666 /ASK -FPPC SCHEDULE A -2 Investments, Income, and Assets of Business Entities/Trusts (Ownership Interest is 10% or Greater) Check one ❑ Trust, go to 2 Business Entity, complete the box, then go to 2 j GENERAL DESCRIPTION OF BUSINESS ACTIVITY ' FAIR MARKET VALUE IF APPLICABLE, LIST DATE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Sole Proprietorship ❑ Partnership ❑ Other YOUR BUSINESS POSITION Check one ❑ Trost, go to 2 ❑ Business Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑$100,001— $1,000,000. ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Sole Proprietorship ❑ Partnership ❑. .Other YOUR BUSINESS POSITION 1T ❑ $0 - S499 ❑ $10,001 - s100,000 $500 - $1,000 ❑ OVER $100,000 $1,001 - $10,000 Check one box: ❑ INVESTMENT ❑REAL PROPERTY ❑ $0 - $499 ❑ $10,001 - $100,000 ❑ $500 - $1,000 ❑ OVER $100,000 ❑ $1,0ol - slo,000 Check one box: :]INVESTMENT REAL PROPERTY Name of Business Entity 1 Street Address or Assessors Parcel Number of Real Property Description of Business Activity or City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000, ❑ $to,00l - $1o0,00o ❑ $100,001 - $1,000,000 ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OF INTEREST - ❑ Property Ownership /Deed of Trust ❑ Stock ❑ Partnership ❑ Leasehold Yrs- remaining ❑ Other Vame of Business Entity pr 31ree1 Address or Assessor's Parcel Number of Real Property Description of Business Activity or City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2.000 - $10,000 ] $10,001 - $10o,000 ] $100,001 - $1,000,000 ACQUIRED DISPOSED ] Over $1,000,000 NATURE OF INTEREST - ] Property Ownership /Deed of Trust ❑ Stock ❑ Partnership ] Leasehold Yrs - remaining I❑ Other FPPC Form 700 (2001/2002) Sch. A -2 FPPC Toll -Free Helpline: 866 /ASK -FPPC SCHEDULE E Income — Gifts > NAME OF SOURCEYY����CC ADDRESM—L�� l3- ✓'�nL -1'/ - 0L�y � , BUSINESS ACTIVITY, IF ANY, OF SOURCE DESCRIPTION OF GIFT (S) VALUE DATE q) YdZ�4wC 4M 11C�p�,}I N NH $ASS -> NAME OF SOURCE BUSINESS ACTIVITY, IF ANY, OF SOURCE DESCRIPTION OF GIFT(S). VALUE DATE $ __j_ /— > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE DESCRIPTION OF GIFT(S) VALUE DATE $ ��— Comments: > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE DESCRIPTION OF GIFT(S) VALUE- DATE $ / __J- $ ��- > 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 (2001/2002) Sch. E FPPC Toll -Free Helpline: 666 /ASK -FPPC