Roush 700 Assuming OfficeCALIFORNIA FORM
FAIR POLITICAL PRACTICES COMMISSION
A PUBLIC DOCUMENT
Please type or print in ink.
STATEMENT OF ECONOMIC INTERES
COVER PAGE
NAME OF FILER (LAST) (FIRST)
ROUSH MICHAEL
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
CITY OF ALAMEDA
Division, Board, Department, District, if applicable
CITY ATTORNEY'S OFFICE
ing Received
Your Position
INTERIM CITY ATTORNEY
o. If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency° 5
2. Jurisdiction of Office (Check at least one box)
0 State
0 Multi-County
City of 1\-1-17)1 6 DA
Position:
7-7/1(71/3 )
0 Judge or Court Commissioner (Statewide Jurisdiction)
El County of
0 Other
3. Type of Statement (Check at least one box)
[j] Annual: The period covered is January 1, 2017, through 0 Leaving Office: Date Left I /
December 31, 2017, (Check one)
-Or-
The period covered is through 0 The period covered is January 1, 2017, through the date of
December 31, 2017. leaving office.
-o r-
12 / 01 / 2018 through
a Assuming Office: Date assumed 0 The period covered is
the date of leaving office.
0 Candidate: Date of Election and office sought, if different than Part 1:
4. Schedule Summary (must complete) ■ Total number of pages including this cover page:
Schedules attached
fl Schedule A-1 - Investments - schedule attached
Schedule A-2 - Investments - schedule attached
0 Schedule B - Real Property - schedule attached
-or-
12 None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY
(Business or Agency Address Recommended - Public Document)
I] Schedule C • Income, Loans, & Business Positions - schedule attached
LI Schedule D - Income - Gifts - schedule attached
0 Schedule E • Income - Gifts - Travel Payments - schedule attached
STATE ZIP CODE
2263 SANTA CLARA AVENUE, #280 ALAMEDA CA 94501
DAYTIME TELEPHONE NUMBER
( 510 ) 747-4750
E-MAIL ADDRESS Ai_ /477 _6124x..7, 6 f-&-
u-S/4- e
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
December 17, 2018
(month, day year)
Signature
'-
(File the originally signed statement with your filing official)
FPPC Form 700 (2017/2018)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
Agency: California Joint Powers Risk Management Authority Position: Alternate Member, Board of
Directors
Agency: Local Agency Workers Compensation Excess Pool; Position: Alternate Member, Board of
Directors