Rosemary Guerrero - Annual 2011s�t ',ev °IV °,<
CALIFORNIA • - 1 1 STATEMENT OF ECONOMIC INTERESTS D
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DOCUMENT FAIR POLITICAL PRACTICES COMMISSION A PUBLIC COVER PAGE CITY CLERKS OFFICC
G11RITY1, CA
Please type or print in ink.
NAME OF FILERS (L�AST)� (FIRST) (MIDDLE)
1. Office, Agency, or Court
Agency Name C
Division, Board, Department, District, if applicable
► If filing for multiple positions, list below or on an attachment.
Your Position
Agency: Position:
2. Jurisdiction of Office (Check at Least one box)
❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ Multi- County ❑ County of
O/City of C4 ❑ Other
3. Type of Statement (Check at least one box)
�nual: The period covered is January 1, 2011, through ❑ Leaving Office: Date Left II
December 31, 2011. (Check one)
-or-
The period covered is I I through
December 31, 2011.
❑ Assuming Office: Date assumed II
❑ Candidate: Election Year
0 The period covered is January 1, 2011, through the date of
leaving office.
0 The period covered is I through
the date of leaving office.
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 attache ❑ 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 ommended . Public Document)
'73 S-1 osJ_.o o �— ,A - 6i'� V 0 q C/ 1- 9 T z o
DAYTIME TELEPHONE
E -MAIL
(OPTIONAL)
Tr x i (,2 - b ��'f
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 "s true and correct.
Date Signed �
3 Signature
(month, d17, year) (File the originally signed atemen ith your
FPPC Form 700 (2011/2012)
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov