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Kim Boris ryF-FA'JFf EL ,,.:I:ara9 CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS l• • •I + <;i l I FAIR POLITICAL PRACTICES COF.MISSION A PUBLIC DOCUMENT COVER PAGE skT' =-,r_rla s ofFtE d4' Please type or punt in ink. _---" '"^- NAME OF FILER (LAST) (FIRST) (MIDDLE) Palmer-Boris Kimbery L 1. Office, Agency, or Court Agency Name (Do not use acronyms) City of Rosemead Division, Board. Department, District, if applicable Your Position Parks 8 Recreation Department Recreation Supervisor • 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(Statevnde Jurisdiction) ❑Multi-County ❑County of j 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 Leff JJ December 31,2014. (Check one) or- The period covered is JJ through O The period covered is January 1,2014,through the date of December 31, 2014. leaving office. ❑ Assuming Office: Date assumed JJ 0 The period covered is JJ—..___,through the date of leaving office. i] 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-I •Investments-schedule attached ❑ Schedule C-Income, Loans. 8 Business Positions-schedule attached ❑ Schedule A•2-Investments–schedule attached ❑ Schedule D• Income-Gilts-schedule attached ❑ Schedule B-Real Properly-schedule attached ❑ Schedule E-Income-GMs- Travel Payments-schedule attached -or- None-No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET CITY STATE ZIP CODE (&&mess at Aa,cy Address Recommended.wart Document) 8838 E.Valley Blvd Rosemead Ca 91770 DAYTIME TELEPHONE NUMBER E-MAIL ADDRESS ( 626 ) 569-2250 kboris©cityofrosemead,org I have used an 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 Hue 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 correct Date Signed 03/16/2015 Signature (mat den rem (fde the Gown*si l sIemenIIM pm Ong deck! FPPC Form 700(2014/2015) FPPC Advice Email:advice @fppcca.gov FPPC toll-Free Helpline:866/275-3772 www.fppc.ca.gov