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Jim GuerraSTATEMENT OF ECONOMIC INTEREST" OF OS�E AB ed Please tvoe or Print in ink A Public Document COVER PAGE MAR 13 2002 NAME (LAST) (FIRST) (MIDDLE) - DAYTIME TELEPHONE NUMBER GUERRA JAMES M 562 908 -6289 MAILING ADDRESS STREET CITY ZIP CODE OPTIONAL: FAX / E -MAIL ADDRESS (May be business address) 13191 CROSSROADS PKWY. N. #405 INDUSTRY CA 91746 jguerra @willdan.com 1. Full Name of Office Sought or Held, Agency or Court: CITY OF ROSEMEAD Division, Board, District, if applicable: Position: CONSULTING BUILDING OFF ICIAL If filing for multiple positions, list additional agency(ies)/ position(s): (Attach a separate sheet if necessary.) Agency: Position Title: 2. Jurisdiction of Office (Check one box) ❑ State ❑ County of rinrit,, ,f ROSEMEAD ❑ Multi- County rT rl}hcr s. Type of Statement (Check at least one box) ❑ Assuming Office /Initial Date: xl Annual: The period covered is January 1, 2001, through December 31, 2001. -or- 0 The period covered is through December 31, 2001. ❑ Leaving Office Date Left: (Check one) • The period covered is January 1, 2001, through the date of leaving office. -or- O 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 [ - schedule attached Investments (La :.s man rocs ow. fdp) Schedule A -2 ❑ Yes - schedule attached Investments (Greater me" roes ow mw*) Schedule B L] Yes - schedule attached Real Property Schedule C © Yes - schedule attached Income & Business Positions paawna Omer mar, L.. Gin; arM Traael) 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 3 -11 -02 \� \\ ( \ manlh, day. year) FPPC Form 700 (2 0 0112 0 0 2) FPPC Toll -Free Helpline: 866/ASK-FPPC SCHEDULE C Income & Business Positions (Income Other than Loans, Gifts, and Travel Payments) > NAME OF SOURCE JAMES M. GUERRA ADDRESS 13191 CROSSROADS PKWY N. #405 BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION CONSULTING BUILDING OFFICIAL GROSS INCOME RECEIVED ❑ $500 - $1,000 0 $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED i] Salary ❑ Spouse's income ❑ Loan repayment ❑ Sale of (Property, car, boat, elcJ ❑ Commission or ❑ Rental Income, list each we" 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 (Properly, car, boat, etc.) ❑ Commission or ❑ Rental Income, list each source of $10,000 or more ❑ Other (Describe) Comments: > NAME OF SOURCE Name JAMES GUERRA 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 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, car, boat, etc.) ❑ Commission or ❑ Rental Income, list each source of $10,000 or more ❑ Other (Describe) FPPC Form 700 (2001/2002) Sch. C FPPC Toll -Free Helioline: 866 /ASK -FPPC