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Mathew Hawkesworth CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS E7@IVED9 CITY OPITOBIEAD FAIR POLITICAL PRACTICES COMMISSION A PUBLIC DOCUMENT COVER PAGE MAR 12 2015 Please type or print in ink % NAME OF FILER (LAST) (FIRST) s_ ��[[ •M�y(MIDULE) kXP Ramirez Michelle G 1. Office, Agency, or Court Agency Name (Do not use acronyms) City of Rosemead Division, Board, Department, District, if applicable Your Position Community Development Department Community Development Director e If fling for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: Position: 2. Jurisdiction of Office (Check at least one box) ❑State ❑Judge or Court Commissioner(Statewide Jurisdiction) ❑Multi-County ❑County of ©City of Rosemead ❑Other 3. Type of Statement (Check at least one box) • Annual: The period covered is January 1, 2014, through ❑ Leaving Office: Date Left_/_r December 31. 2014. (Check one) -Or- The period covered is_r_/ ,through 0 The period covered is January 1, 2014, through the date of December 31, 2014. leaving office. ❑ Assuming Office: Date assumed__J_/ 0 The period covered is_/_/ , 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: ❑ 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 or Agency Address Recommended-Public Document) 8838 E. Valley Boulevard Rosemead CA 91770 DAYTIME TELEPHONE NUMBER E-MAIL ADDRESS ( 626 ) 569-2158 mramirez @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 codify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date Signed 03/12/2015 Signature A . . 4. . ' 6Als (monln,day yen) (File The ommelly signed yialement yellow-r•ofMlaL) FPPC Form 700(2014/2015) FPPC Advice Email:advice @fppc.ca.gov FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov RECEIVED rrfl'irQElR05a 40 CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS Receiver: ,,A FAIR POLITICAL PRACTICES COMMISSION MAR:1 2 7015 A PUBLIC DOCUMENT COVER PAGE Please type or pant in ink CITY CLERK'S OFFICE NAPE OF FILER (LAST) (FIRST) 2 (Mr Hawkesworth Matthew Edward 1. Office, Agency, or Court Agency Name (Do not use acronyms) City of Rosemead Division, Board, Department, District,if applicable Your Position Assistant City Manager H If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency. -- Position: 2. Jurisdiction of Office (Check at least one box) ❑State ❑Judge or Court Commissioner(Statewide Jurisdiction) ❑Multi-County ❑County of z City of Rosemead _-_ ❑Omer - _ 3. Type of Statement (Check at least one box) © Annual: The period covered is January 1, 2014, through ❑ Leaving Office: Date Left__J r December 31,2014. (Check one) -or- Dec period covered is ,through 0 The period covered is January 1, 2014,through the date of �� December 31, 2014. leaving office. ❑ Assuming Office: Date assumed j' 0 The period covered is—(_/ ,through the date of leaving office. ❑ Candidate: Election year and office sought, if different than Pan 1 4. Schedule Summary Check applicable schedules or"None." • Total number of pages including this cover page: 2 ❑ Schedule A-I -Investments-schedule attached ❑ Schedule C•Income. Loans. &Business Positions-schedule attached ❑ Schedule A-2-Investments-schedule attached 0 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 (eusiess orAgencyAddress Recommended-Pudic Document) 8838 Valley Blvd Rosemead CA 91770 DAYTIME TELEPkONE NUMBER E-MAIL ADDRESS ( 626 ) 569-2107 mhawkesworth @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 an correct Date Signed 03/12/2015 Signature I'v 1 month.day Had ` (Re theengm N 6Aed nmemen,wiyour'Jog oft/y FPPC Form 700(2014/2015) FPPC Advice Email:advice @fppc.ca.gov FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov CALIFORNIA FORM 700 SCHEDULED FAIR POLITICAL PRACTICES COMMISSION Income — Gifts Name • NAME OF SOURCE (Not an Acronym) • NAME OF SOURCE(Not an Acronym) Burke,Williams and Sorenesen, LLP ADDRESS(Business Address Acceptable) ADDRESS(Business Address Acceptable) 444 South Flower Street Suite 2400, Los Angeles BUSINESS ACTIVITY,IF ANY. OF SOURCE BUSINESS ACTIVITY. IF ANY OF SOURCE City Attorney DATE(mMtlNyy) VALUE DESCRIPTION OF GIFT(S) DATE(mm/dd/yyl VALUE DESCRIPTION OF GIFT(S) 09 0414 $ 110.67 Dinner �� $ _1_ $ _1_1— $ _1_1 • NAME OF SOURCE(Not an Acronym) • NAME OF SOURCE(Not an Acronym) ADDRESS(Business Address Acceptable) ADDRESS(Business Address Acceptable) BUSINESS ACTIVITY IF ANY OF SOURCE BUSINESS ACTIVITY IF ANY.OF SOURCE DATE(mm/ddlyy) VALUE DESCRIPTION OF GIFTIS) DATE(mm/ddlyy) VALUE DESCRIPTION OF GIFT(S) ��— $ e NAME OF SOURCE(Not an Acronym) NAME OF SOURCE(Not an Acronym) ADDRESS(Business Address Acceptable) ADDRESS(Business Address Acceptable) BUSINESS ACTIVITY. IF ANY OF SOURCE BUSINESS ACTIVITY, IF ANY OF SOURCE DATE(mmlddlyy) VALUE DESCRIPTION OF GIFT(S) DATE(mm/ddlyy) VALUE DESCRIPTION OF GIFT(S) Comments: FPPC Form 700(2014/201S)Sch.0 FPPC Advice Email:advice @fppc.ca.gov FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov