Michelle Ramirez •
CALIFORNIA FORM Dare InitialFhr'a
700 STATEMENT OF ECONOMIC INTERESTS
FAIR P
O ITICAL P SAC TIC e S COMMISSION CITY
A PUBLIC DOCUMENT COVER PAGE BY: cl._r rs
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Please type or print in ink
NAME OF FILER (LAST) (FIRST) (MIDDLE)
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 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 ._.—
City of Rosemead ❑Other
3. Type of Statement (Check at least one box)
]ac Annual: The period covered is January 1, 2016, through E Leaving Office: Date Lett J J
December 31,2016. (Check one)
or-
The period covered is , Through O The period covered is January 1, 2016.through the date of
December 31, 2016. leaving office.
-or-
] Assuming Office: Date assumed Jj O The period covered is_r_/ 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: 2
Schedules attached
Schedule A-1 -Investments-schedule attached ]Schedule C-Income, Loans, 8 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
MAILINC ADDRESS 5-BEET CITY STATF ZIP CODE
(ewlress or Agency Address Recommended PublicDocument)
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 certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct
Date Signed 03/02/2017 Signaturerl,ct
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FPPC Form 700(2016/2011)
FPPC Advice Email:advice@fppc.ca.gov
FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov
CALIFORNIA FORM 700
SCHEDULE D FAIR POLITICAL PRACTICES commiSSlor,
Name
Income — Gifts
Michelle G. Ramirez
F NAME OF SOURCE(Not an Acronym) or NAME OF SOURCE(Not an Acronym)
Unknown-received at employee Christmas Party
ADDRESS(Business Address Acceptable) ADDRESS(Business Address Acceptable)
Unknown
BUSINESS ACTIVITY IF ANY OF SOURCE BUSINESS ACTIVITY IF ANY.OF SOURCE
Unknow
DATE(mmld&yy) VALUE DESCRIPTION OF GIFT(S) DATE Imm/dNyy) VALUE DESCRIPTION OF GIFT(S)
12 15 16 $50 Gift Card-Lucille's BBC1 JJ
J-_J—
Sa NAME OF SOURCE(Not an Acronym) IR 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 ImMddlyy) VALUE DESCRIPTION OF GIFTIS) DATE(mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
JJ 5 JJ $ _-
JJ a JJ $
JJ S JJ S
Sa NAME OF SOURCE (Not an Acronym) Y 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(mnVdd/yy) VALUE DESCRIPTION OF GIFT(S) DATE ImmIdd/yy) VALUE DESCRIPTION OF GIFT(S)
J S J $
Comments:
FPPC Form 700(2016/2017)Sch.D
FPPC Advice Email:advice@fppc.ca.gov
FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov