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Sandra ArmentaSTATEMENT OF ECONOMIC INTERESTS COVER PAGE Please type or print in ink. APR Q 2 12 mwmur nLrn )Lnm) )nnc,) , __, )miuuLt) r Armenta Sandra i "•� k+ 1. Office, Agency, or Court Agency Name Rosemead Community Development Commission Division, Board, Department, District, if applicable Your Position Commissioner ► If filing' for multiple positions, list below or on an attachment. Agency: Position: 2. Jurisdiction of Office (check at least one box) ❑ Stale ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ Multi- County ❑ County of i] City of Rosemead ❑ Other 3. Type of Statement (Check at tease one box) ❑ Annual: The period covered is January 1, 2011, through I] Leaving Office: Date Left —0 2012 December 31, 2011. _ (Check one) -or- The period covered is through O The period covered is January 1, 2011, through the date of December 31, 2011. leaving office. ❑ Assuming Office: Date assumed O The period covered is through the date of leaving office. ❑ Candidate: Election Year Office sought, if different than Part 1: 4. Schedule Summary Check applicable schedules or " None." ► Total number of pages including this cover page: 2 ❑ Schedule A -1 - Investments - schedule attached ❑ Schedule C - Income, Loans, & Business Positions - schedule attached ❑ Schedule A -2 - Investments - schedule attached ❑X Schedule D - Income - Gifts - schedule attached ❑ Schedule 8 - Real Property - schedule attached ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached -or- None - No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET CITY STATE ZIP CODE (Business or Agency Address Recanmended - Public Document) 8838 E. Vallev Boulevard Rosemead CA 91770 626 ) 569 -2100 1 sarmenta @cityofrosemead.org 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 acknowledge this is a public document. I certify under penalty of perjury under the laws of the State of Czlifornia that the foregoing is true and correct. Date Signed March 30, 2012 Signature brolk day, year) (File @e cdgio,dlysigned stafeWnf Kith your Poing Mfia' .) FPPC Form 700 (2011/2012) FPPC Toll -Free Helpline: 8661275 -3772 worm1ppc.ca.gov, SCHEDULE D Income — Gifts ► NAME OF SOURCE League of California Cities Latino Caucus ADDRESS (Business Address Acceptable) 770 L Street, Suite 1030 Sacramento, CA 95814 BUSINESS ACTIVITY, IF ANY, OF SOURCE Latino Caucus Annual Board Retreat, Los Angeles DATE (mm /dd /yy) VALUE DESCRIPTION OF GIFT(S) 01 21 / 11 s 83.00 Informal Dinner 01 / 22 11 $ 94.00 Sponsor Dinner __J __j $ ► NAME OF SOURCE Athens Services ADDRESS (Business Address Acceptable) 5355 Vincent Avenue Irwindale, CA 91706 BUSINESS ACTIVITY, IF ANY, OF SOURCE CA Contract Cities Annual Municipal Conference DATE (mmtdd /yy) VALUE DESCRIPTION OF GIFT(S) 05 / 13 / 11 $ 100.00 Sponsor Dinner —1 —J— $ ► NAME OF SOURCE ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm /dd /yy) VALUE DESCRIPTION OF GIFT(S) __ J __J S -J $ Comments: Name Sandra L Armenta ► NAME OF SOURCE League of California Cities Latino Caucus ADDRESS (Business Address Acceptable) 770 L Street, Suite 1030 Sacramento, CA 95814 BUSINESS ACTIVITY, IF ANY, OF SOURCE League of CA Cities Annual Conference /San Fran DATE (mm/ddlyy) VALUE DESCRIPTION OF GIFT(S) 09 j / 11 $ 89.00 Sponsor Dinner 09 j / 11 $ 13.00 Gala Reception $ 0 NAME OF SOURCE Athens Services ADDRESS (Business Address Acceptable) 5355 Vincent Avenue Irwindale, CA 91706 BUSINESS ACTIVITY, IF ANY, OF SOURCE Independent Cities Installation DATE (mm /dd /yy) VALUE DESCRIPTION OF GIFT(S) 09 / 16 / 11 % 62.50 Installation Dinner ► NAME OF SOURCE ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm/ddtyy) VALUE DESCRIPTION OF GIFT(S) __J $ ��- $ FPPC Form 700 (2011/2012) Sch. D FPPC Toll -Free Helpline: 866 /275 -3772 w fppc.ca.gov P 1 STATEMENT OF ECONOMIC IN Uk§,Ts '_ ' • • COVER PAGE j AN d 2 1012 Please type or print in ink. NAME OF FILER (LAST) (FIRST) MIDDLE)i Armenta Sandra 1. Office, Agency, or Court Agency Name City of Rosemead Division, Board, Department, District, if applicable Your Position City Council Council Member ► If filing for multiple positions, list below or on an attachment. Agency: Position: 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ Multi- County ❑ County of ❑x City of Rosemead ❑ Other 3. Type of Statement (Check at least one box) ❑x Annual: The period covered is January 1, 2011, through ❑ Leaving Office: Dale Left __J__J December 31, 2011. (Check one) -or- The period covered is through O The period covered is January 1, 2011, through the date of December 31, 2011. leaving office. ❑ Assuming Office: Date assumed ---J---J O The period covered is J I , through the date of leaving office. ❑ Candidate: Election Year Office sought, if different than Part 1: 4. Schedule Summary Check applicable schedules or " None. ° o- Total number of pages including this cover page. 2 ❑ Schedule A -1 - Investments- schedule attached ❑ Schedule C - Income, Loans, & Business Positions - schedule attached FJ Schedule A -2 - Investments- schedule attached ❑X Schedule D - Income - Gifts- schedule attached ❑ Schedule B - Real Property - schedule attached ❑ Schedule E - Income - Gifts - Travel Payments- schedule attached .or- El None - No reportable interests on any schedule 5. Verification MNLING ADDRESS STREET CITY STATE ZIP CODE (Business ur Agency Address Recommended Public Document) 8838 E. Valley Boulevard Rosemead CA 91770 DAYI TELEPHONE NUMBER E -MAIL ADDRESS (OPTIONAL) ( 626 ) 569 -2100 sarmenta @cityofrosemead.org 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 acknowledge this is a public document. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date Signed March 30, 2012 Signature � (momh day, year) (rile the aigiiw! /y sigiuds aternere wbh�ffing effmi.J FPPC Form 700 (2011/2012) FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov SCHEDULE D Income — Gifts ► NAME OF SOURCE League of California Cities Latino Caucus ADDRESS (Business Address Acceptable) 770 L Street, Suite 1030 Sacramento, CA 95814 BUSINESS ACTIVITY, IF ANY, OF SOURCE Latino Caucus Annual Board Retreat, Los Angeles DATE (mm /dd /yy) VALUE DESCRIPTION OF GIFT(S) Of / 21) 11 S 83.00 Informal Dinner 01 122 1 11 $ 94.00 Sponsor Dinner $ ► NAME OF SOURCE Athens Services ADDRESS (Business Address Acceptable) 5355 Vincent Avenue Irwindale, CA 91706 BUSINESS ACTIVITY, IF ANY. OF SOURCE CA Contract Cities Annual Municipal Conference DATE (mm /dd /yy) VALUE DESCRIPTION OF GIFT(S) 05 / 13 / 11 $ 100.00 Sponsor Dinner ► NAME OF SOURCE ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm /dd /yy) VALUE DESCRIPTION OF GIFT(S) __j --- J $ Comments: Name Sandra L Armenta ► NAME OF SOURCE League of California Cities Latino Caucus ADDRESS (Business Address Acceptable) 770 L Street, Suite 1030 Sacramento, CA 95814 BUSINESS ACTIVITY, IF ANY, OF SOURCE League of CA Cities Annual Conference /San Fran DATE (mm/dd /yy) VALUE DESCRIPTION OF GIFT(S) 09/221 $ 89.00 Sponsor Dinner O9 j _22 / 11 $ 13.00 Gala Reception __J __J— $ ► NAME OF SOURCE Athens Services ADDRESS (Business Address Acceptable) 5355 Vincent Avenue Irwindale, CA 91706 BUSINESS ACTIVITY, IF ANY, OF SOURCE Independent Cities Installation DATE (mm/ddtyy) VALUE DESCRIPTION OF GIFT(S) 09j_161 11 $ 62.50 Installation Dinner ► NAME OF SOURCE ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm /dd/yy) VALUE DESCRIPTION OF GIFT(S) % $ FPPC Form 700 (2 0 1112 0 1 2) Sch. D FPPC Toll -Free Helpline: 8661275 -3772 www.fppc.ca.gov