Roush 700CALIFORNIA FORM
700
FAIR POLITICAL PRACTICES COMMISSION
Please type or print in ink.
NAME OF FILER (LAST)
Roush
STATEMENT OF ECONOMIC INTEREST
COVER PAGE
A PUBLIC DOCUMENT
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of Alameda, Interim City Attorney
Division, Board, Department, District, if applicable
(FIRST)
Michael
Your Position
■ If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
see attached
Agency:
H
Position: see attached
ith4tfing
Official Use Only
FEB 25 2019
CITY OF ALAMEDA
1011
2. Jurisdiction of Office (Check at least one box)
E1State
0 Multi-County
LI City of Alameda
0 Judge or Court Commissioner (Statewide Jurisdiction)
0 County of
0 Other See attached
3. Type of Statement (Check at least one box)
[XI Annual: The period covered is January 1, 2018, through
December 31, 2018.
The period covered is _/ /
December 31, 2018.
• Assuming Office: Date assumed /
-or-
O Candidate: Date of Election
through
0 Leaving Office: Date Left /_/
(Check one circle.)
o The period covered is January 1, 2018, through the date of
-or-
leaving office,
O The period covered is through
the date of leaving office.
and office sought, if different than Part 1:
4. Schedule Summary (must complete) Total number of pages including this cover page: --'--
Schedules attached
O Schedule A-1 - Investments — schedule attached
O Schedule A-2 - Investments — schedule attached
O Schedule B - Rea/ Property — schedule attached
-or- None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET
(Business or Agency Address Recommended - Public Document)
2263 Santa Clara Street,
DAYTIME TELEPHONE NUMBER
510 )747 4756
CITY
Alameda
0 Schedule C - Income, Loans, & Business Positions — schedule attached
0 Schedule D - Income — Gifts — schedule attached
Schedule E - Income — Gifts — Travel Payments — schedule attached
STATE
CA 94501
EMAIL ADDRESS
mroush@alamedacityattorney.org
ZIP CODE
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 February 25, 2019 Signature
(month, day, year) (File the originally signed paper statement with your Ring official.)
CE
FPPC Form 700 (2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov
Page - 5
ATTACHMENTTO FORM 700 1/1/18 to 12/31/18
Agency Name: City of Brisbane, Position: City At orney
Agency Name: California Joint Powers Risk Management Authority, Position: Alternate Board Member
Agency Name: Local Agency Workers Compensation Excess Coverage Joint Powers Authority,
Position: Alternate Board Member