Nancy ValderamaCALIFORNIA
FORM
700
FAIR PDLfY1CAL PRACTICES
COMMISSION
Please type or print in ink
COVER PAGE. MAR 0 5 2002
NAME / (LAST) (FIRST) (MIDDLE) WRE NUMBER
MAILING ADDRESS STREET CITY ZIP CODE OPTIONAL: FAX / E -MAIL ADDRESS
(May be business address)
3 g 6_1 AGC.E X A&VID, sGWLIL. 9/ 776
1. Full Name of Office Sought or Held,
Agency or Court-
4) /7 OF �aSE/�1���
Division, Board, District, it applicable:
Position:
L /T� GGEx
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
]Cityot sC ,
❑ Multi- County
❑ Other
3. Type of Statement (Check at least one box)
❑ Assuming Office /Initial Date:
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: _l am
(Check one)
Q The period covered is January 1, 2001, through
the date of leaving office.
-or-
0 The period covered is _lam, through
the date of leaving office.
❑ Candidate
Date Received
STATEMENT OF ECONOMIC INTEREU� ���.� Use o,a,
A Public Document 'CITY OF ROSEMEAD
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 lass than loss Ownersmp)
Schedule A -2 ,❑ Yes - schedule attached
investments iGrealerfhan 10 %0wnersnipf -
Schedule B- .❑Yes - schedule attached
Real Property -.. _.
Schedule C ❑ Yes - schedule attached:
Income & Business Positions (income Omer than Loans. Gifts, and Travel)
Schedule D ❑ Yes - schedule attached
Income - Loans
Schedule E RrYes - 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: �
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 AAA, � i Liz
(month, day, day, year)
Signature _ ��L
(File the originally - signed statement with your filing official.)
FPPC Form 700 (2001/2002)
FPPC Toll -Free Helpline: 666 /ASK -FPPC
SCHEDULE E
Income — Gifts
> NAME OF SOURCE
-
�tJiLGDA�
V- 4S56ey.
ADDRESS
BUST ESS 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
Comments:
VALUE DATE
> NAME OF SOURCE
ADDRESS
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DESCRIPTION OF GIFT(S)
> NAME OF SOURCE -
ADDRESS
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DESCRIPTION OF GIFT(S)
VALUE DATE
$ _ J_ J_
VALUE - DATE
$ _ �—
$ _/ —/
NAME OF SOURCE
ADDRESS
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DESCRIPTION OF GIFT(S)
FPPC Form 700 (2001/2002) Sch. E
FPPC Toll -Free Helpline: 866 /ASK -FPPC