William OrnelasSTATEMENT OF ECONOMIC
COVER PAGE
Please type or print in ink. - �,;�F -', = — °-- -- -._I
CTj r_ 6 fl „ i�
NAME OF FILER (LAST) (FIRST) By (MIDDLE)
ORNELAS William —_
1. Office, Agency, or Court
Agency Name
CITY OF ROSEMEA PUBLI SERVICES MAN
Division, Board, Department, District, tt applicable Your Position
PUBLUC WORKS
► If filing for multiple positions, list below or on an attachment.
Agency:
Position:
2. Jurisdiction of Office (check at feast one box)
❑ State
❑ Multi- County
Ex] City of R OSEMEAD
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of LOS AN GELES
❑ Other
3. Type of Statement (check at least one box)
❑x Annual: The period covered is January 1, 2011, through ❑ Leaving Office: Date Left)
-or-
December 31, 2011. (Check one)
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 dale 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:
❑ Schedule A -1 - Investments - schedule attached
❑ Schedule C - Income, Loans, & Business Positions - schedule attached
❑ Schedule A -2 - Investments - schedule attached
❑ Schedule D - Income - Gifts - schedule attached
❑ Schedule B - Real Property - schedule attached
❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
-or-
❑X None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET
CITY STATE ZIP CODE
(Business w Agency Address Recanmended - Public Document)
945 WINDSONG COURT
(� /�jy{(eu �je CA 91765
DAYTIME TELEPHONE NUMBER
E -MAIL ADDRESS (OPTIONAL)
( 626 ) 945-8037
ORNELAS B1 @VERIZON.NET
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my Iml dge 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 c rect.
��-
Date Signed 7"
Signature`
(month, day, year)
(File the ngm signed s emenl Ailh yourfiling olfiml.)
\- ...__. FPPC Form 700 (2 01112 0 1 2)
FPPC Toll -Free Helpline: 8661275 -3772 www.fppc.ca.gov