John ScottV
Please type or print in ink.
STATEMENT OF ECONOMIC IN
COVER PAGE
A Public Document
(FIRST) (MIDDLI
John
1G ADDRESS STREET CITY
sas Address Acceptable)
Butte St. Claremont
1 . Office, Ag ency, or Court
Name of Office, Agency, or Court:
City of Rosemead; Public works
Division, Board, District, if applicable:
Public Services
Your Position:
Public Services Superintendent
► If filing for multiple positions, list additional agency(ies)f
postion(s): (Attach a separate sheet if necessary)
Agency:
Position:-------------------------------------------- --------------------------
-`-
2. Jurisdiction of Office (check at least one box)
State
County of
0 City of Rosemead
1 . Multi- County
n Other
3. Type of Statement (check at least one box)
-' -'• Assuming Offcellnitiel Date:
X Annual: The period covered is January 1, 2009,
through December 31, 2009.
-or-
0 The period covered is through
December 31, 2009.
❑ Leaving Office Date Left:
(Check one)
p The period covered is January 1, 2009, through the
date of leaving office.
-or-
0 The period covered is through
the date of leaving office.
Candidate Election Year:
MAR 3 1 2010
C11 "'(
OFFICE
( 626 ) 569 -2260
ZIP CODE I
I OPTIONAL: E -MAIL A
Ca i 91711
4. Schedule Summary
► Total number of pages 20
including this cover page: m...,..
► Check applicable schedules or "No reportable
interests."
I have disclosed interests on one or more of the
attached schedules:
Schedule A -1 ❑ Yes - schedule attached
Investments (Less than 10% ownership)
Schedule A -2 i._l Yes - schedule attached
Investments (70% w Greater Ownership)
Schedule B ❑ Yes - schedule attached
Real Property
Schedule C ❑ Yes - schedule attached
Income, Loans, & Business Positions (Income Omer man Gigs
and Travel Payments)
Schedule D ❑ Yes - schedule attached
Income - Gifts
Schedule E ❑ Yes - schedule attached
Income - Gifts - Travel Payments
-or-
X11 No reportable Interests on any schedule
5. Verification
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 certify under penalty of perjury under the laws of the State
of California that the foregoing is true and correct.
Date Signed 03 -18 -10
(month, day, year)
Signature '
(File me origmalN signed statement wdh your li!ing o/fide/)
FPPC Form 700 (2 0 0 912 01 0)
FPPC Toll -Free Helpline: 866 /ASK -FPPC www.fppe.c .gov