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Sandra Armentay Daft ducccidcs ice' 1 IV M STATEMENT OF ECONOMIC INTERESTS j — r. COVER PAGE I � Please type or print in ink. -' NAME OF FILER (FAST) (FIRSL { _ 7..... e2'. Armenta, Sandra - 1. Office, Agency, or Court Agency Name City of Rosemead Division Boar, Department, Distr w If filing for multiple positions, list below or on an attachment. Agency Position Council Member Position. 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ Mulii -County ❑ County of © City of Rosemead ❑ Other 3. Type of Statement (check at least one box) Annual: The period covered is January 1, 2012, through ❑ Leaving Once: Date Leff JJ December 31 2012. (Check one) -or. O The period covered is January 1, 2012, through the date of The embed covered is —J .through ffice. December 31 2012, leaving o ❑ Assuming Office: Date assumed O The period covered is —J through the date of leaving office. ❑ Candidate: Election year and office sought if different than Pad 1 4. Schedule Summary Check applicable schedules or °None, ° Total number of pages including this cover page: ❑ Schedule A-I - Investments- schedule attached ❑ Schedule C - Income, Loans & Business Positions - schedule attached ❑ Schedule A -2 - Invesf ni- schedule attached Schedule D - Inrome- Gifts - schedule attached ❑ Schedule a - Real Pmpeny- Schedule attached ❑ Schedule E - Income - Gifts - Tavel Payments- schedule attached -or- E] None - No Deportable whereas, on any schedule 5. Verification MAILING?oORESS srREET em sT4TE ZIP Gore ouslmos o- Agv,er Aa SS awemmemed. Puhfc oaomua) 9428 Olney St Rosemead CA 91770 _ pAttIME TELFSHONE NOMPER EMAIL ADDRESS (OPTION',` ( 626 ) 676-3965 Sandralarmenta @gmail.com I have used all reasonable diligence In preparing this statement. I have reviewed this statement and to the best of my knowledge the Informahoo contalnad herein and In any attached schedules is me and complete. I acknowledge this is a public document. I certify under penalty of perlury under the laws of the State of California that the foregoing is true and correct. Date Signed 04/01/2013 Signature % Immmmnyeed r`ne me eAUaaN+noeo Ace —,soh ,r imee la) FPPO Form 700 (20122013) FPPCAdvice Email: adviceuifereori gov FPPC Toll Free Helpltne. 86612)531]2 www.fppc.ca.gov SCHEDULE D Income - Gifts li� NAME OF SOURCE (Not an Acmnym) League of CA Cities - Latino Caucus ADDRESS D ine55 Atltlress Acceptable) 770 L Street, Suite 1030 Sacramento, CA 95814 BUSINESS ACTIVITY, IF ANY OF SOURCE Latino Caucus Board Retreat DATE (mnVddlyy) VALUE DESCRIPTION OF GIFTS) 01 r 13 l 12 45.00 Friday Lunch 01 l 13 r 12 E 46.00 Friday Dinner 01 J 14 l 12 s 30.00 Saturday Breakfast li� NAME OF SOURCE (Nat an Acmnym) League of CA Cities - Latino Caucus ADDRE55 (Business Atltlress Accepable) 770 L Street, Suite 1030 Sacramento, CA 95814 BUSINESS ACTIVITY IF ANY OF SOURCE Latino Caucus Mid- Year Board Retreat DATE (ETTIdlyy) VALUE DESCRIPTION OF GIFTS) 07 l 06 r 12 s 12.00 Friday Reception 07 l 06J 12 s 5470 Friday Dinner 07 107 r 12 45.00 Saturday Breakfast NAME OF SOURCE (Not an Acmnym) League of CA Cities - Latino Caucus ADDRESS (Business Address ACCeOtable) 770 L Street, Suite 1030 Sacramento, CA 95814 BUSINESS ACTIVITY, IF ANY OF SOURCE League of California Cities Annual Conference DATE (mmlddlyy) VALUE DESCRIPTION OF GIFTIS) 09 ( 07J 12 s 26.11 Reception O9 J 07 r 12 s 75,45 Dinner JJ_ 5 Comments. CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION .I NAME OF SOURCE (Not an Acmnym) League of CA Cities - Latino Caucus ADDRESS (business Addrea AAMIR RI 770 L Street, Suite 1030 Sacramento, CA 95814 BUSINESS ACTIVITY IF ANY OF SOURCE Latino Caucus Board Retreat DATE OnAl yyl VALUE DESCRIPTION OF GIFFS) 01 r 14 l 12 s 40.00 Saturday Lunch Ol J 14 l 12 s 131.00 Saturday Dinner 01 l 14 l 12 E 25.00 Sunday Breakfast . NAME OF SOURCE (Not an ACronym) League of CA Cities - Latino Caucus ADDRESS rbusmess Add— Acceptable) 770 L Street, Suite 1030 Sacramento, CA 95814 BUSINESS ACTIVITY IF ANY OF SOURCE Latino Caucus Mid- Year Board Retreat DATE SOnddiyy) VALUE DESCRIPTION OF OTTO) 07) 07 J 12 s 42.00 Saturday Lunch 07 l 07) 12 E 80.00 Saturday Dinner 07J 08J 12 s 35.00 Sunday Breakfast ll� NAME OF SOURCE (Not anAcranym) Republic Services ADDRESS (eueness AdI Acceptable) 2531 E. 67th St. Long Beach, 90805 BIT NESS ACTIVITY, IF ANY OF SOURCE Entertainment DATE (mmlddryy) VALUE DESCRIPTION OF GIFTS O4) 13 t 12 s 50.00 LA Laker Ticket J 01 J 12 s 50.00 LA Laker Ticket Jam— E FPPC Form 700 (201212013) Sch. D FPPC Advice Email. aovice@fppc.ca.gov FPPC Toll Free Helpllne. 8661275 3772 www.fppC.Ca gov SCHEDULE D Income - Gifts NAME OF SOURCE (Nat an Acmnym) Burke, Williams, and Sorensen, LLP ADDRESS (Business Addreaa Acoeptabh) 444 South Flower St, Suite 2400 BUSINESS ACTIVITY i IF ANY OF SOURCE _ League of California Cities Annual Conference DATE (mm /ddlyy) VALUE DESCRIPTION OF GIFTS) 09 (06 r 12 s 1 1 lD Dinner JJ— s JJ— s NAME OF SOURCE (Not an Acmnym) Archie Davenport ADDRESS (Business Address Acceptable) Pasadena, CA www.dmrelations.com BUSINESS ACTIVITY IF ANY OF SOURCE Entertainment DATE (mMdd/yy) VALUE DESCRIPTION OF GIFTIS) 05 129) 12 s 55.00 LA Dodger Ticket J 21J 12 s 24.00 Dinner JJ S NAME OF SOURCE (Not anACmnym) ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY IF ANY OF SOURCE DATE (mmldd /yy) VALUE DESCRIPTION OF GIFTS) JJ J� 5 J— 5 Comments: CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION oe NAME OF SOURCE (Not an Acmnym) Burke, Williams, and Sorensen, LLP ADDRESS (Business Address Acceptable) 444 South Flower St, Suite 2400 BUSINESS ACTIVITY, IF ANY OF SOURCE California Contract Cities Association Municipal Conf DATE (mmlddlyy) VALUE DESCRIPTION OF CIFT(S) 05J 18J 12 E 1 —� Dinner JJ— s le NAME OF SOURCE (Not an Acmnym) ADDRESS (eusmeas Addmas Aaaepleblm BUSINESS ACTIVITY IF ANY OF SOURCE DATE (mmmdlyy) VALUE DESCRIPTION OF GIFTS) JJ— E JJ— 5 NAME OF SOURCE (Nat as Acmnym) ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY. IF ANY OF SOURCE DATE nin AMlyy) VACJE DESCRIPTION OF GETS) E JJ— b FPPC Farm 700 (2012/2013) SCIP 0 FPPC Advice Email advice @Tppc.Ca.gov FPPC Toll Free Helpline: 8661275 3772 www 1ppc.ca. gov