Michelle Ramirez(-' Date Received
STATEMENT OF ECONOMIC INTERESTS O ^iaiaf u5.Only
COVER PAGE 3
Please type or print in ink. 1 -1
NAME OF FILER (LAST) (FIRST) (MIDDLE)
Ramirez
Michelle
Gayle
1. Office, Agency, or Court
Agency Name
City of Rosemead
Division, Board, Department, District, if applicable Your Position
Community Development Department
► If fling for multiple positions, list below or on an attachment.
Development Director
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
the date of leaving office.
❑ State
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ Multi- County
❑ County of
❑ City of
❑ Other
3. Type of Statement (Check at least one box)
❑ Schedule C - Income, Loans, & Business Positions - schedule attached
❑,/ Annual: The period covered is January 1, 2012, through
❑ Leaving Office: Date Left ---- J___J
December 31, 2012.
(Check one)
-or-
The period covered is through
O The period covered is January 1, 2012, through the dale of
December 31, 2012.
leaving office.
❑ Assuming Office: Date assumed ___J__J
O The period covered is __J - — - J , through
the date of leaving office.
❑ Candidate: Election year and
office sought, if different than Part 1:
4. Schedule Summary
Check applicable schedules or " None."
► Total number of pages including this cover page: 1
❑ 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-
None - No
reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET
CITY STATE ZIP CODE
(Business a Agency Address Recommended - Pubic Document)
8838 E. Valley Boulevard
Rosemead CA 91770
DAYTIME TELEPHONE NUMBER
E -MAIL ADDRESS (OPTIONAL)
( 626 ) 569 -2158
mramirez @cityofros
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 iis true and correct. r
02/20/2013
Date Signed
Signatur rn&�� AA
(month, day, year)
IFilelheodginadysunedslalemeMwslhyourrdlnyo 'al.)
FPP or 700 (2012/2013)
FPPC Advice Emai : advice0P ppc.ca.gov
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov