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Roderick Omelas RECEIVED CITY OF PncrMFAD CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS FAIR eAuPUBLIC COMMISSION DOCUMENT COVER PAGE CITY CLERK'S OFFICE BY:_ Please type or print in ink. ------ NAME OF FILER (LAST) FIRST) (MIDDLE) Ornelas Roderick 1. Office, Agency, or Court Agency Name (Do not use acronyms) City of Rosemead Division. Board. Department,District, if applicable Your Position Traffic Commission Commissioner • 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 Cowl Commissioner(Statewide Jurisdiction) ❑Multi-County ❑County of ▪City of Rosemead n Other 3. Type of Statement (Check at least one box) IZ Annual: The period covered is January 1, 2015,through ❑ Leaving Office: Date Left J� December 31,2015. (Check one) -or- The period covered is January 1, 2015, through the date of Dec period covered is J� through 0 n rY 9 December 31,2015. or leaving office. ❑ Assuming Office: Date assumed ij 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 (must complete) ► Total number of pages including this cover page: Schedules attached ❑ Schedule A-1•Investments-schedule attached $Schedule C•Income,Loans, IS Business Positions-schedule attached ❑ Schedule A-2-Investments-schedule attached ❑Schedule D-Income-Gifts-schedule attached ❑ Schedule B-Peal Property-schedule attached ❑Schedule E-Income-Gifts-Tmvel Payments-schedule attached -or- • None• No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET mY STATE ZIP CODE (Buses or Agency Address Recommended-Pudic Document) 8838 East. Valley Boulevard Rosemead CA 91770 DAYTIME TELEPHONE NUMBER EMAIL ADDRESS ( 626 ) 569-2100 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 and dccc000rrrect. Date Signed 4/?'�//G Signature �^`�`1A °' " emmld day year) (Ale the an ioaIiy VanS#&emenl with your fire utak) FPPC Form 700(2015/2016) FPPC Advice Email:advice @fppc.ca.gov FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov • SCHEDULE C CALIFORNIA FORM 700 Income, Loans, & Business FAIR POLITICAL PRACTICES COMMISSION • Positions Name (Other than Gifts and Travel Payments) 1.INCOME RECEIVED • 1.INCOME RECEIVED NAME OF SOURCE OF INCOME NAME OF SOURCE OF INCOME 4 T ADDRESS(Business Address Acceptable) ��// ADDRESS(Business Address Acceptable) X633 GR74NO Sr ti srJ7EAD BUSINESS ACTIVITY IF ANY,OF SOURCE BUSINESS ACTIVITY, IF ANY,OF SOURCE YOUR BUSINESS POSITION YOUR BUSINESS POSITION SPVC/,V - rscN, GROSS INCOME RECEIVED GROSS INCOME RECEIVED O$500-$1,000 ❑$1,001 -$10,000 ❑$500-$1,000 ❑$1001 -$10,000 ty$10,001 -$100,000 ❑OVER$100.000 ❑$10,001 -$100,000 ❑OVER$100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED CONSIDERATION FOR WHICH INCOME WAS RECEIVED XI Salary E Spouse's or registered domestic partner's income E Salary E Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.) (For self-employed use Schedule A-2.) ❑Partnership(Less than 10%ownership.For 10%or greater use ❑ Partnership(Less than 10%ownership.For 10%or greater use Schedule A-2) Schedule A-2) ❑ Sale of ❑sale of (Real property car,boar.etc, (Real pmwM.®[ms eh) I] Loan repayment U Loan repayment O Commission or E Rental Income,e9 each source of Dm.000 or mare E Commission or E Rental Income,car earn sowca ol$10.000 or mom (Qsocee) (Poxnee) ▪Other E Other (CCrmbe) NesvNe) * You are not required to report loans from commercial lending institutions, or any indebtedness created as part of a retail installment or credit card transaction, made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows: NAME OF LENDER' INTEREST RATE TERM(Months/Years) % None ADDRESS(Business Address Acceptable) SECURITY FOR LOAN BUSINESS ACTIVITY, IF ANY.OF LENDER ❑ None E Personal residence O Real Properly HIGHEST BALANCE DURING REPORTING PERIOD Srreel address U$500-$1,000 Ley ▪$1.001-510,000 ❑Guarantor $io,001 -$100,000 El OVER$100000 E Other (De scebe) Comments: FPPC Form 700(2015/2016)Sch.C FPPC Advice Email:advice@fppc.ca.gov FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov