David Montgomery-ScottDate Received
STATEMENT OF ECONOMIC INTERESTS ommr O5e 0 "1Y
COVER PAGE
Please type or print in ink.
NAME OF FILER (LAS) (FIRST) (MIDDLE)
Montgomery-Scott David Gregory
1. Office, Agency, or Court
Agency Name
City of Rosemead
Division, Board, Department, District, if applicable Your Position
Parks and Recreation Department Parks and Recreation Director
► If filing for multiple positions, list below or on an attachment.
Agency:
Position:
2, Jurisdiction of Office (Check at least one box)
❑ State ❑ Judge (Statewide Jurisdiction)
❑ Multi -County ❑ County of
® City of Rosemead ❑ Other
3. Type of Statement (Check at least one box)
❑X Annual: The period covered is January 1, 2010, through December 31, ❑ Leaving Office: Dale Left —J
2010. -0r (Check one)
The period covered is through December 31, O The period covered is January 1, 2010, through the date of
2010. leaving office.
❑ Assuming Office: Date O The period covered is through the date
of leaving office.
❑ Candidate: Election Year Office sought, 9 different than Pad 1:
4. Schedule Summary
Check applicable schedules or "None." ► Total number of pages including this cover page: 1
❑ Schedule A -1 - Investments - schedule attached ❑ Schedule C - Income, Loans, 8 Business Positions - schedule attached
❑ Schedule A -2 - Investments - schedule attached ❑ Schedule D - Income - Gifts - schedule attached
❑ Schedule B - Real Property - schedule attached ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
-or-
❑X None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business o Agerx yAddmss Recommended - Public Document)
8838 E. Valley Boulevard Rosemead CA 91770
( 626 ) 569 -2161 1 dms @cityofrose
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and
herein and in any attached schedules is true and complete. I acknowledge this is a public dOCOmE
I certify under penalty of perjury under the laws of the State of California that the foregoing
Date Signed 03/14/2011
(month, ft year)
best of my knowledge the information contained
correct.
omcq
FPPC Form 700 (2 01 012 011)
Helpline: 8661275.3772 www.fppc.ca.gov