Daniel ScottSTATEMENT OF ECONOMIC INTERESTS
Please type or print in ink
NAME (LAST)
(FIRST)
Scott Daniel
MAILING ADDRESS STREET CITY
(May use business address)
COVER PAGE
A Public Document
400 N. Citrus Ave. Covina
1 . Office, Agency, or Court
Name of Office, Agency, or Court:
City of Rosemead (LA County) Fire
Division, Board, District, if applicable:
Fire Department
Your Position:
Assistant Fire Chief
�+ 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 feast one box)
❑ Stale
® County of Los Angeles
❑ City of
❑ Multi- County
❑ Other
3. Type of Statement (Check at least one box)
❑ Assuming Office /Initial Date: --J--]
.J Annual: The period covered is January 1, 2004,
through December 31, 2004.
-or-
0 The period covered is through
December 31, 2004.
❑ Leaving Office Date Left:
(Check one)
O The period covered is January 1, 2004, through the
date of leaving office.
-or-
0 The period covered is through
the date of leaving office.
❑ Candidate
t�'a�,F�'ec�iVed
CITY 0FojFW_ OMEAD
P4 1 0 Z005
CITY CLER OFFIC
(MIDDLE) DAYTIME TELEPHONE NUMBER
B.
CODE OPTIONAL: FAX I E -MAIL ADDRESS
CA 91723
4. Schedule Summary
(Check applicable schedules or "No reportable interests. ")
During the reporting period, did you'have any reportable
interests to disclose on:
Schedule A -1 ❑ Yes - schedule attached
Investments (Lass than 10% ownership) '
Schedule A -2 ❑ Yes - schedule attached
Investments (10% or greaser ownership)
Schedule B ❑ Yes - schedule attached
Real Property
Schedule C ❑ Yes - schedule attached
Income, Loans, & Business Positions (Income other than Gift and
Travel Payments)
Schedule D (Eliminated - report loans on Schedule C)
Schedule E ❑ Yes - schedule attached
Income - Gifts
Schedule F ❑ Yes - schedule attached
Income - Travel Payments
-or-
No reportable interests on any schedule
Total number of pages
completed including this cover page: 1
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 arch 8, 2005
( u day, year
signature
r �
(File the originally signed statement with your dung ofitlalJ
FPPC Form 700 (200412005)
FPPC Toll -Free Helping: 866 1ASK -FPPC