Michelle RamirezSTATEMENT OF ECONOMIC
COVER PAGE
Please type or print in ink.
Ramirez
1. Office, Agency, or Court
(FIRST)
Michelle
FEB 13 2012
Agency Name
City of Rosemead
Division, Board, Department, District, if applicable Your Position
Community Development Department Acting Community Development Director
► If filing for multiple positions, list below or on an attachment.
Agency:
Position:
2. Jurisdiction of Office (check at least one box)
❑ State
❑ Multi- County
❑ City of —
❑ County of
❑ Other
3. Type of Statement (check at least one box)
x❑ Annual: The period covered is January 1, 2011, through
December 31, 2011.
-or-
The period covered is
December 31, 2011.
❑ Assuming Office: Date assumed
❑ Candidate: Election Year
O The period covered is —
the dale of leaving office.
Office sought, if different than Part 1:
through
4. Schedule Summary
Check applicable schedules or "None. "
❑ Schedule A -1 - Investments - schedule attached
❑ Schedule A -2 - Investments- schedule attached
❑ Schedule B - Real Property - schedule attached
❑ Schedule C - Income, Loans, & Business Positions - schedule attached
X1 Schedule D - Income - Gifts - schedule attached
❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
-or-
F None - No reportable interests on any schedule
5. V e ri fication
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Pubic Document)
8838 E. Valley Boulevard Rosemead CA 91770 -1714
( 626 ) 569 -2158 1 mramirez @cityo
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 penally of perjury under the laws of the Stale of California that the foregoing is true and
Date Signed 02/13/2012
tmmm, coy, year)
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ Leaving Office: Date Left I I
(Check one)
through O The period covered is January 1, 2011, through the date of
leaving office.
► Total number of pages including this cover page. 2 -
FPPorm 700 (2011/2012)
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov
SCHEDULE D
Income — Gifts
Name
Michelle G. Ramirez
► NAME OF SOURCE
Stan & Pat Wong
ADDRESS (Business Address Acceptable)
2650 E Foothill Blvd., Ste. 201, Pasadena, CA 91107
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Government Solutions Associates, Inc. (Consultant)
DATE (mm /dd /yy) VALUE DESCRIPTION OF GIFT(S)
11 j ) 11 $ 80 Holiday Dinner Party
__J/ $
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd /yy) VALUE
__J __J $
__J __J $
__J __J— $
DESCRIPTION OF GIFT(S)
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd/yy) VALUE
/ —/ $
__J__J_ $
__J __J $
Comments:
DESCRIPTION OF GIFT(S)
I ► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd/yy) VALUE
$
__J __J $
DESCRIPTION OF GIFT(S)
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /ddtyy)
VALUE DESCRIPTION OF GIFT(S)
$
$
► NAME OF SOURCE
ADDRESS (Business
Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd /yy)
VALUE DESCRIPTION OF GIFT(S)
__J __J
$
__J __J
$
__J __J
$
FPPC Form 700 (2011/2012) Sch. D
FPPC Toll -Free Helpline: 866 /275 -3772 w .fppc.ca.gov