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Jim GuerraDate Received STATEMENT OFECONOTQ� TARE fir, OlficialUse Only A Public DgfTfizL�4t : J Please type or print in MAR 6 2nntl'� 0 NAME (LAST) (FIRST) DAYTIME TELEPHONE NUMBER GUERRA JIM CITY 'S OFFICE (562 ) 908 -6289 MAILING ADDRESS - STREET CITY ZIP CODE OPTIONAL: FAX / E -MAIL ADDRESS (May be business address) 13191 CROSSROADS PKWY., STE. 405 INDUSTRY CA 91746 -3497 (562) 695 -2120 COVER PAGE 1. Office, Agency, or Court Provide precise name. Do not use acronyms. C ITY OF ROSEMEAD Division, Board, District, if applicable: Position: C ONSULTING BUILDING OFFTCTAT -1 Expanded Statement - List agency /position: (Attach a separate sheet if necessary. Do not use acronyms.) Agency: Position Title: 2. Office Jurisdiction (Check one) ❑ State ❑ County of ❑ Multi- County ❑ Other 3. Type of Statement (Check at least one box) ❑ Assuming Office /Initial Date:--J---J— ® Annual (Check one) Q The period covered is January 1, 1999, through December 31. 1999. 0 The period covered is December 31, 1999. through ❑ Leaving Office Date Left: (Check one) O The period covered is January 1, 1999, through the date of leaving office. 0 The period covered is through the date of leaving office. ❑ Candidate 4. Schedule Summary (Check applicable schedules or "No reportable interests. ") y During the reporting period, did you have any reportable interests to disclose on: Schedule A -1 ❑ Yes - schedule attached Investments (Less than 10% Ownership) Schedule A -2 ❑ Yes - schedule attached Investments (Greaterthan toss ownership) Schedule B ❑ Yes - schedule attached Real Property Schedule C ® Yes - schedule attached Income & Business Positions liscone Other than Loans, Gilts, and Travel) Schedule D ❑ Yes - schedule attached Income - Loans Schedule E ❑ Yes - schedule attached Income - Gifts Schedule F ❑ Yes - schedule attached Income - Travel Payments w ❑ No reportable interests Total number of pages (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. Executed on (month, day, year) SIGNATURE (File th originally signed statement with your filing officer.) FPPC Form 700 (1999/2000) For Technical Assistance: 916/322 -5660 Schedule A -1 Investments Stocks, Bonds, and Other Interests (Ownership Interest is Less Than 10 %) > NAME OF BUSINESS ENTITY > NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY GENERAL DESCRIPTION OF BUSINESS. ACTIVITY FAIR MARKET VALUE FAIR MARKET VALUE ❑ $1,000 - $10,000 ❑ $1,000 - $10,000 ❑ $10,001 - $100,000 ❑ $10,001 - $100,000 ❑ Over $100,000 ❑ Over $100,000 NATURE OF INVESTMENT NATURE OF INVESTMENT ❑ Stack ❑ Stock ❑ Other ❑ Other - (Describe) (Describe) IF APPLICABLE, LIST DATE: IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED ACQUIRED DISPOSED > NAME OF BUSINESS ENTITY > NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $1,000 - $10,000 ❑ $10,001 - $100,000 ❑ Over $100,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Desmbe) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED > NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $1,000 - $10,000 ❑ $10,001 - $100,000 ❑ Over $100,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Desmbe) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED Comments: FAIR MARKET VALUE ❑ $1,000 - $10,000 ❑ $10,001 - $100,000 ❑ Over $100,000 _ NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) IF APPLICABLE, LIST DATE: --j—/ -- j--j --L 9 - ACQUIRED DISPOSED > NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $1,000 $10,000 ❑ $10,001 - $100,000 ❑ Over $100,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) IF APPLICABLE, LIST DATE: --J--J --i—J 99 ACQUIRED DISPOSED FPPC Form 700 (199912000) Sch. A -1 Schedule A -2 Investments, Income, and Assets of Business Entities/Trusts (Ownership Interest is 10% or Greater) Name Check one ❑ Trust, go tv 2 ❑ Business Entity, complete the box, then go to 2 DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE IF APPLICABLE, LIST DATE: - $1,000 - $10,000 ❑ $10,001 - $100.000 J—j ❑ Over $700,000 ACQUIRED DISPOSED NATURE OF INVESTMENT ❑ Sole Proprietorship ❑ Partnership YOUR BUSINESS POSITION ❑ $0 - $249 ❑ $250 - $1,000 ❑ $1,001 - $10,000 ❑ OVER $10,000 Check one box: ❑ INVESTMENT ❑ REAL PROPERTY Name of Business Entity ar 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 ❑ $1,000 - $10,000 ❑ $10,001 - $100,000 ❑ Over $100,000 NATURE OF INTEREST ❑ Property Ownership /Deed of Trust ❑ Leasehold Yrs. remaining ❑ Other ❑ Other IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED ❑ Stock ❑ Partnership Check one box: ❑ INVESTMENT ❑ REAL PROPERTY Name of Business Entity or 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: ❑ $1,000 - $10,000 ❑ $10,001 - $100,000 — 99 ❑ Over $100,000 ACQUIRED DISPOSED NATURE OF INTEREST ❑ Property Ownership /Deed of Trust ❑ Stock ❑ Partnership ❑ Leasehold Yrs. remaining ❑ Other Check one box: ❑ INVESTMENT ❑ REAL PROPERTY Name of Business Entity or 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 ❑ $1,000 - $10,000 ❑ $10,001 - $100,000 ❑ Over $100,000 NATURE OF INTEREST ❑ Property Ownership /Deed of Trust IF APPLICABLE, LIST DATE: 99 99 ACQUIRED DISPOSED ❑ Stock ❑ Partnership ❑ Leasehold Yrs. remaining ❑ Othel FPPC Form 700 (199912000) Sch. A -2 Schedule B Interests in Real Property OR PRECISE LOCATION CITY FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $1,000-$10000 , / 99 �� 99 ❑ --J $10,001 - $ 100,000 ACQUIRED DISPOSED ❑ Over $100,000 NATURE OF INTEREST OF INTEREST ❑ Rental Property ❑ Ownership /Deed of Trust ❑ Easement ❑ Leasehold ❑ Leasehold ❑ Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $249 ❑ $250 - $1,000 ❑ $1,001 - $10,000 ❑ Over $10,000 SOURCES OF RENTAL INCOME: If you own 10% or greater interest, see the instructions for reporting sources of rental income. NAME OF LENDER ADDRESS BUSINESS ACTIVITY OF LENDER ❑ Financial Institution ) Other INTEREST RATE TERM (Months /Years) ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $250 - $1,000 ❑ $1,001 - $10,000 ❑ Over $10,000 ❑ Guarantor, if applicable Check below if another loan is disclosed on Schedule D. ❑ Additional loan - refer to Sch. D. Comments: ADDRESS OR PRECISE LOCATION CITY FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $1,900 - $10,000 —J� 99 �� 99 ❑ $10,001 - $100,000 ACQUIRED DISPOSED ❑ Over $100,000 NATURE OF INTEREST ❑ Rental Properly ❑ Ownership /Deed of Trust ❑ Easement ❑ Leasehold ❑ Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $249 ❑ $250 - $1,000 ❑ $1,001 - $10,000 ❑ Over $10,000 SOURCES OF RENTAL INCOME: If you own a 10% or greater interest, see the instructions for reporting sources of rental income. NAME OF LENDER ADDRESS BUSINESS ACTIVITY OF LENDER ❑ Financial Institution 11 nther INTEREST RATE TERM (MonlhsNears) % ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $250 - $1,000 ❑ $1,001 - $10,000 ❑ Over $10,000 ❑ Guarantor, if applicable Check below if another loan is disclosed on Schedule D. ❑ Additional loan — refer to Sch. D. FPPC Form 700 (1999/2000) Sch. B For Technical Assistance: 9161322 -5660 Schedule C Income & Business Positions (Income Other than Loans, Gifts, and Travel Payments) > NAME OF SOURCE JIM GUERRA ADDRESS 13191 CROSSROADS PKWY. INDUSTRY CA 91746 -3497 BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION CONSULTING BUILDING OFFICAI GROSS INCOME RECEIVED ❑ $250 - $1,000 [1 $1,001 - $10,000 ❑ Over $10,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ® Salary ❑ Spouse's income ❑ Loan repayment ❑ Sale of (Property, car, boat, etc) ❑ Commission or ❑ Rental Income, net each source of 510,000 or more ❑ Other (Describe) > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $250 - $1,000 ❑ $1,001 - $10,000 ❑ Over $10,000 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 JIM GUERRA > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $250 - $1,000 ❑ $1,001 - $10,000 ❑ Over $10,000 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 ( Descnbe) > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $250 - $1,000 ❑ $1,001 - $10,000 ❑ Over $10,000 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 ( Descnbe) FPPC Form 700 (199912000) Sch. C For Technical Assistance: 9161322.5660 Schedule D Income — Loans (Received or Outstanding) NAME OF LENDER ADDRESS BUSINESS ACTIVITY OF LENDER ❑ Financial Institution ❑ Other INTEREST RATE TERM (Months/Years) ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $250 - $1,000 ❑ $1,001 - $10,000 ❑ Over $10,000 SECURITY FOR LOAN ❑ None ❑ Automobile ❑ Personal residence ❑ Real Property Sfreef address ❑ Guarantor ❑ Other NAME OF LENDER ADDRESS BUSINESS ACTIVITY OF LENDER ❑ Financial Institution F nth., INTEREST RATE TERM (Months/Years) % ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $250 - $1,000 ❑ $1,001 - $10,000 ❑ Over $10,000 SECURITY FOR LOAN ❑ None ❑ Automobile ❑ Personal residence ❑ Real Properly ❑ Guarantor ❑ Other _ (Oescnbe) Comments: _ NAME OF LENDER ADDRESS BUSINESS ACTIVITY OF LENDER ❑ Financial Institution n INTEREST RATE TERM (Months /Years) ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $250 - $1,000 ❑ $1,001 - $10,000 ❑ Over $10,000 SECURITY FOR LOAN ❑ None ❑ Automobile ❑ Personal residence ❑ Real Property ❑ Guarantor ❑ Other _ 1 NAME OF LENDER ADDRESS BUSINESS ACTIVITY OF LENDER ❑ Financial Institution ❑ Other INTEREST RATE TERM (Months /Years) ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $250 - $1,000 ❑ $1,001 - $10,000 _❑ Over $10,000 SECURITY FOR LOAN ❑ None ❑ Automobile ❑ Personal residence ❑ Real Property Street addm s ❑ Guarantor ❑ Other FPPC Form 700 (199912000) Sch. D For Technical Assistance: 916/322 -5660 Schedule E > NAME OF SOURCE Income — Gifts > N AM OURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE DESCRIPTION OF GIFT(S) VALUE DATE $ ��— S ��— $ ��— > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE DESCRIPTION OF GIFT(S) VALUE DATE $ --J --J— $ — / —_ /— $ --J --J— >' NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE DESCRIPTION OF GIFT(S) VALUE DATE $ ��— $ --J--J Comments- ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE DESCRIPTION OF GIFT(S) VALUE DATE $ --J --J— $ --J --J— $ --J --J— > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE DESCRIPTION OF GIFT(S) VALUE DATE $ --J --J— $ ��— $ — /�— > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE DESCRIPTION OF GIFT(S) VALUE DATE $ --J --J— $ --J --J— $ --J —/— FPPC Form 700 (199912000) Sch. E For Technical Assistance: 916/322 -5660 Schedule F Income — Gifts Travel Payments, Advances, and Reimbursements *NAME OF SOURCE ADDRESS CITY AND STATE BUSINESS ACTIVITY, IF ANY, OF SOURCE TYPE OF PAYMENT: (check one) ❑ Gift ❑ Income AMT: $ DATE(S): (if applicable) DESCRIPTION: *NAME OF SOURCE ADDRESS CITY AND STATE BUSINESS ACTIVITY, IF ANY, OF SOURCE TYPE OF PAYMENT: (check one) ❑ Gift ❑ Income AMT: $ DATE(S): (if applicable) DESCRIPTION: * NAME OF SOURCE ADDRESS CITY AND STATE BUSINESS ACTIVITY, IF ANY, OF SOURCE TYPE OF PAYMENT: (check one) ❑ Gift ❑ Income AMT. % DATE(S): (if applicable) DESCRIPTION: Comments: )-NAME OF SOURCE ADDRESS CITY AND STATE BUSINESS ACTIVITY, IF ANY, OF SOURCE TYPE OF PAYMENT: (check one) ❑ Gift ❑ Income AMT: $ DATE(S). (Ifapplicable) DESCRIPTION: )-NAME OF SOURCE ADDRESS CITY AND STATE BUSINESS ACTIVITY, IF ANY, OF SOURCE TYPE OF PAYMENT: (check one) ❑ Gift ❑ Income AMT: $ DATE(S): J--J— (Ifapplicable) DESCRIPTION: *NAME OF SOURCE ADDRESS CITY AND STATE BUSINESS ACTIVITY, IF ANY, OF SOURCE TYPE OF PAYMENT: (check one) ❑ Gift ❑ Income AMT: $ DATE(S): ( Ilapplicable) DESCRIPTION: FPPC Form 700 (1999/2000) Sch. F For Technical Assistance: 9161322 -5660