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Daniel ScottMAR. -24' 03 (MON) 16:56 CITY OF ROSEMEAD TEL :626- 301-9218 STATEMENT OF ECONOMIC INTERESTS COVER PAGE eluase rvna nr nrlmm ink A Public Document P. 002 � iYlWeived ' MAR 2 d) 2003 4 I Y ULLRK' OFFICF NAME (LAST) (FIRST) (MIDDLEI DAYTIME TELEPHONE NUMBER Scott Daniel B. (626 )974 -8371 MAILING ADDRESS STREET CITY ZIP CODE OPTIONAL: FAX I EMAIL ADDRESS (may be buslness sadress) 400 N. Citrus Avenue Covina 91723 I . Office, Agency or Court Name: City of Rosemead (LA Couaty) Fire Division, Board, District, if applicable: Fire DepartMent Position: Assistant Fire Chief If filing for multiple positions, list additional agoncy(ies)/ poaition(s): (Attach a separate shoat if necessary.). Agency: Position_ 2. Jurisdiction O f Office (check Of least one box) ❑ State ® County of Los Angeles ❑ City of ❑ Multi- County ❑ Other 3. Type of Statement (Check at least one box) ❑ Assuming Office /Initial Date:--J R1 Annual; The period covered is January 1, 2002, through December 31, 2002. -or- 0 The period covered is — /�„ through December 31, 2002. ❑ Leaving Office Date Left: (Check one) • The period covered is January 1, 2002, through The Pate of leaving office. .or- • The period covered is J I through the date of leaving office. ❑ Candidate 4. Schedule Summary (Cheek applicable schedules or "No raparlable infarasts -') During the reporting Period, did you have any reportable interests to disclose on: Schedule A -1 ❑ Yes - schedule attached Investments (Less man +or. omarsnm) Schedule A -2 ❑ Yes - schedule attached im nom or gmara. pmyrsmpt Schedule B Yes - schedule attached Real Property Schedule C ❑ Yes - schedule attached Income & Business Positions pnaome omer men Lama, cma aad Tmwp Schedule D ❑ Yes - schedule attached Income - Loans 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 ano correct. Data Signed MM _ t 24, 2003 (mooch, da , yeaq Signature Ie Ina mginally signed slatamen rvll your Illmg I.,, FPPC Form 700 (200212003) FPPC Toll -Free Heloline: 866 1ASK -FPPC