Matt HawkesworthSTATEMENT OF ECONOMIC
Please type or print in ink.
COVER PAGE
A Public Document
BY
NAME (LAST)
(FIRST)
(MIDDLE)
DAYTIME TELEPHONE NUMBER
Hawkesworth
Matthew
Edward
( 626 ) 569 -2107
MAILING ADDRESS STREET
CITY
STATE
ZIP CODE
OPTIONAL: E -MAIL ADDRESS
(Business Address Acceptable)
8838 E Valley Blvd
Rosemead
CA
91770
1 . Office, Agency, or Court
Name of Office, Agency, or Court:
City of Rosemead
Division, Board, District, if applicable:
City Manager's Office
Your Position:
Assistant City Manager
► If filing for multiple positions, list additional agency(ies)/
position(s): (Attach a separate sheet if necessary.)
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ County of
[] City of Rosemead
❑ Multi -County
❑ Other
3. Type of Statement (Check at least one box)
❑ Assuming Office /Initial Date:
(] 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)
O 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:
4. Schedule Summary
► Total number of pages 1
including this cover page:
► 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 ❑ Yes - schedule attached
Investments (1o% or Greater Ownership)
Schedule B ❑ Yes - schedule attached
Real Property
Schedule C ❑ Yes - schedule attached
Income, Loans, & Business Positions pncome other than Gins
and Travel Payments)
Schedule D ❑ Yes - schedule attached
Income - Gifts
Schedule E ❑ Yes - schedule attached
Income - Gilts - Travel Payments
Date Received
f4lA [T"YT 9 J6J0
CITY CLERX. ; f7EFICE
-or-
® 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 March 3, 2010
(month, day, year)
Signature
(File A onginally Ignell statement with your Ming official)
FPPC Form 700 (2 0 0 912 01 0)
FPPC Toll -Free Helpline: 866/ASK-FPPC www.fppc.ca.gov