Merced Ortiz' � STATEMENT OF ECONOMIC INTEREST
g I n ed
CALIFORNIAFOR A Public Document OF ROSEMEAD
. � MAR 1 J 2002
Please type or print in ink D V P L I CAT gVER PAGE
NAME (LAST) (FIRST) - (MIDDLE) DAYTIME E NE ^ NUMBER
fr Z Mel-ced
MAILING ADDRESS - REET CITY ZIP CODE OPTIONAL: FAX / E -MAIL ADDRESS
(May be business address)
3 'YOq At, Koc v /. e L77Q
1. Full Name of Office Sought or Held,
Agency or Court:
Division, Board, District, if applicable:
Position: r
PLa a0/ b 1WAni5SfG�I2�
If filing for multiple positions, list additional agency(ies)/
position(s): (Attach a separate sheet it necessary.)
Agency:
Position Title:
2. Jurisdiction of Office (Check one box)
❑ State
❑ County of �9 /
[ ity of M £'A.Gf
❑ Multi- County
❑ Other
3. Type of Statement (Check at least one box)
❑ Assuming Office /Initial Dale: —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: __J ___1_
(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
r4. Schedule Summary
II (Check applicable schedules or "No reportable interests.')
I.. During the reporting period, did you have any reportable
interests to disclose on:
Schedule A -1
❑ Yes – schedule attached
Investments (Less than
10% ownershq)
Schedule A -2
❑ Yes – schedule attached
Investments (G.eaier than 7mu ownersho I -
Schedule B
❑ Yes – schedule attached
Real Property
-
Schedule C
❑ Yes – schedule attached
Income & Business
Positions (Income Other than Loans. Gifts, and Travel)
Schedule D
❑ Yes – schedule attached
Income – loans
Schedule E
❑ Yes – 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:
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 J / F C
(month, day, year)
Signature
FPPC Form 700 (2001/2002)
FPPC Toll -Free Helpline: 866 1ASK -FPPC
CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
STATEMENT OF ECONOMIC INTERESTS Date Received
OHieial Use Only
A Public Document D UP LI CATE
COVER PAGE
NAME _ (LAST) - (FIRST) (MIDDLE) DAYTIME TELEPHONE NUMBER
7 2� "e x-e e7 2 1r2- -& -610s
MAILING ADDRESS STREET CITY ZIP CODE
OPTIONAL: FAX / E -MAIL ADDRESS
(May be business address)
3 D/ Nr V��'K�c, / 4e. �3s�mc.9� x/776
1. Full Name of Office Sought or Held, Agency
or Court:
Division, Board, District, if applicable:
Position: /
E t 1q- /41tJ14JC'
• 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 /f
OCity of
❑ Multi- County
❑ Other
I. 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 _/ ___J_, through
December 31, 2001.
❑ Leaving Office Date Lett:
(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.
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 flan fax Ow arshlol
Schedule A -2 ❑ Yes — schedule attached
Investments (Greater than ]ex Ownership)
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 ❑ 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: -
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
(month, day, year)
7
Signature
(File the originally sign i- stalemen),pWth your filing official.)
❑ Candi
FPPC Form 700 Amendment (200112002)
FPPC Toll -Free Helpline: 666 /ASK -FPPC
FAIR POLITICAL PRACTICES COMMISSION
P.O. Box 807 • 428 J Street • Sacramento, CA 95812 -0807
(916) 322 -5660 • Fax (916) 322 -0886
May 13, 2002
Merced Ortiz
Planning Commissioner
City of Rosemead
3409 N Rockhold Avenue
Rosemead, California 91770
Re: Statement of Economic Interests
Type of Statement: Annual
Date Filed: March 19, 2002
Dear Ms. Ortiz:
The Fair Political Practices Commission received your statement of economic interests (Form
700). A review of your statement indicates that further information is required as explained on the
attachment.
The enclosed amendment schedule(s) should be completed within 20 days and returned to Nancy
Valderrama, City Of Rosemead, who will retain a copy and forward the original to the Fair Political
Practices Commission. Please retain a copy of the amendment schedule(s) for your records to assist you
in completing future statements of economic interests.
Please note that our review of your statement does not constitute an in depth audit and your
compliance with this request for amendment information or correction does not relieve you of
responsibility for the overall accuracy and completeness of your statement as required by law.
We are here to assist you. If you have any questions, please call me at (916) 327 -5966.
Sincerely, {
Cyndi Glaser
Staff Services Analyst
Technical Assistance Division
cc: Nancy Valderrama
N�
Attachment for letter to:
Merced Ortiz
May 13, 2002
FPPC: 916.327.5966
We have listed below information in your statement of economic interests (Form 700)
which may require correction or clarification:
On the Cover Page, Part 4, Schedule Summary, you did not indicate whether Schedules A -1 through F
were attached or that you have no reportable interests. If we do not hear from you within 30 days, we
will assume that you have no further reportable interests. If you had reportable interests during the
reporting period which were not disclosed on your statement, please contact the Commission to obtain
the appropriate amendment schedules. Also, Part 3, Type of Statement was not marked.