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John ScottDate Received STATEMENT OF ECONOMIC INTERE�TSr�LIVED t,aenn, A Public Document CITY OF ROSEMEAD Please type or print in ink - COVER PAGE MAR 2 5 2002 NAME (LAST) . (FIRST) (MIDDLE)' ONE NUMBER 5GIW ;I A/ 6RY4tat" ( 6Z() MAILING ADDRESS STREET CITY ZIP CODE OPTIONAL: FAX I E -MAIL ADDRESS (May be business address) 1 -In 014,66 P0/A()A/A 1. Full Name of Office Sought or Held, Agency or Court: Division, Board, District, it applicable: Position: DANK - 5tAPpl 'TL1VDtn7I If filing for multiple positions, list additional agency(ies)/ position(s): (Attach -a separate sheet if necessary.) Agency: Position Title: 2. Jurisdiction of Office (Check one box) ❑ State ❑County of /� City of 965F—/4Grl'✓ ❑ Multi- County ❑ Other 3. Type of Statement (Check at least one box) ❑ Assuming Office /Initial Date: Annual: The period covered is January 1, 2001 hrough December 31, 2001. - -or- 0 The period covered is December 31. 2001. through ❑ Leaving Office Date Left: __J ___1_ (Check one) - O The period covered is January 1, 2001, through the date of leaving office. -or- 0 The period covered is through the date of leaving office. ❑ Candidate 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. �es — schedule attached investments (Less than T0% ownership) - Schedule A -2 ❑ Yes – schedule attached Investments (Greater than 10% ownership) Schedule B ; <Yes – schedule at Real Property Schedule C ;�SYes – schedule attached Income & Business Positions (Income other than Loans. Gifts, and Travel) 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: 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 : /i � ///��,,, (Month day, � year) Signature (File the originally signed statement with your fling official.) FPPC Form 700 (200112002) FPPC Toll -Free Helpline: 666 /ASK -FPPC SCHEDULE A -1 Investments Stocks, Bonds, and Other Interests Name (Ownership Interest is Less Than 10 %) folill �ca > NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE — �$2,000 - $10,000 ❑ $10,001 . $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other luescrioe) IF APPLICABLE, LIST DATE: ACQUIRED - DISPOSED > NAME OF BUSINESS ENTITY Vy+pm/o Iylvt tMw'o`1s GENERAL DESCRIPTION DE�ESCyN�AA IP yn RIPTIONOF BUSINESS ACTIVITY FAIR MARKET VALUE _KS2,000 $10000 ❑ $10,001 - $100,000. ❑ S100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT x Stock ❑ Other IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED > NAME OF BUSINESS ENTITY �( e '# GENERAL DESCRIPTION OF BUSINESS ACTIVITY - ha �&yy mp FAIR MARKET VALUE $2,000 - $10,000 ❑ $100,00, - $1,000,000 NATURE OF INVESTMENT Stock ❑ Other IF APPLICABLE, LIST DATE: ❑ $10,001 - $100,000 ❑ Over $1,000,000 j_ / 01 ACQUIRED DISPOSED Comments > NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $1oo,001 - $1,00g000 ❑ over $1.000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED > NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE. ❑ $2,000 - $10,000 - ❑ $10,001 - $100,000 ❑ $loo,00l - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) IF APPLICABLE, LIST DATE: � / 01 —l ,ACQUIRED. DISPOSED - > NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 - ❑ over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED FPPC Form 700 (2001/2002) Sch. A -1 FPPC Toll -Free Helpline: 866 /ASK -FPPC SCHEDULE B Interests in Real Property > STREET ADDRESS OR PRECISE LOCATION i'In W r'b m/oo.) PIA -E CITY - f 2 op loklA. - - FAIR MARKET VAL E IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 01 J 1 01 ❑ $1o,001 - $100,000. __j -J $100,007 - $1,000,000 ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OFINTEREST ❑ Rental Property Ownership /Deed of Trust ❑ Easement ❑ Leaseholtl ❑ Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $4e9 ❑ $500 - $1.000 ❑ $1,o01 - $10,00o ❑ $10,001 - $100,000 ❑ OVER $100,000 SOURCES OF RENTAL INCOME. If you own a 10% or greater interest, list the name of each tenant that is a single source of income of $10,000 or more. NAME OF LENDER - - I - 13 &ik bf A Mai d-A- ADDRESS. P,0 &)(- x'7/'77 Sam J"Aycl' (X 0/37 BUSINESS ACTIVITY OF LENDER �KF i nan ma I Institution ❑ Other �TE�IINTERQ RATE 0 'S./! % ❑ None TERM (Months /Years) 1 HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,o0o ❑ $1,0ol - $10,000 ❑ $10,001 - $100,000 ;91�VER $100,000 ❑ Guarantor, if applicable Check below if another loan is disclosed on Schedule D. ❑ Additional loan - refer to Sch. D. - Comments: > STREET ADDRESS OR PRECISE LOCATION CITY FAIR MARKET VALUE - IF APPLICABLE, LIST DATE. []. $2,000 - $10,000 ❑ $10,001 - $100,000 01 __J__j 01 ❑ $100,001- $1,000,000 ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OFINTEREST ❑ Rental Property ❑ Ownership /Deed of Trust ❑ Easement ❑ Leasehold ❑ Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $ass ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 SOURCES OF RENTAL INCOME: If you own a 10% or greater interest, list the name of each tenant that is a single source of income of $10,000 or more. NAME OF LENDER ADDRESS BUSINESS ACTIVITY OF LENDER ❑ Financial Institution ❑ Other INTEREST RATE % ❑ None TERM (Months/Years) HIGHEST BALANCE DURING REPORTING PERIOD ❑ $50o - $1,000 ❑ $1,001 - $10,0o0 ❑ $10,001 - $100,000 ❑ OVER $100,000 ❑ Guarantor, if applicable Check below if another loan is disclosed on .Schedule D. ❑ Additional loan - refer to Sch. D. FPPC Form 700 (2001/2002) Sch. B FPPC Toll -Free Helpline: 866 /ASK -FPPC SCHEDULE C Income & Business Positions (Income Other than Loans, Gifts, and Travel Payments) > NAME OF SOU CE ri6 ADDRESS P t__� PDM120AlA BUSI ACTIVITY, IF ANY, SOUF�T YOUR BUSINESS POSITION Vofe�gl Nil GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑ $1,001 - $10,000 '$10,001 - - - $10o,000 ❑ OVER $100,000 CONSIDERATION. FOR WHICH INCOME WAS RECEIVED Salary - ❑ Spouse's income ❑ Loan repayment ❑ Sale of - - (Propery; car, boat, etc) ❑ Commission or -❑ Rental Income, list each source or $10,000 or more ❑ Other (Describe) > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED. - ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's income ❑ Loan repayment ❑ Sale of .(Property, car, boat, etc.) ❑ Commission or F� Rental Income, list each source of 510,000 or more ❑ Other Comments: > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑ $1,001 - $10.000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's income ❑ Loan repayment ❑ Sale of (Prooeny, car, opal, e¢.) ❑ Commission or ❑ Rental Income, hsr each source or 510.000 or more ❑ Other (Describe) > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ sloxi - siouti0 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's income ❑ Loan repayment ❑ Sale of (Properly, car, boat etc.) ❑ Commission or ❑ Rental Income, rsr each source or Sio,000 or more ❑ Other FPPC Form 700 (2001/2002) Sch. C FPPC Tall -Free Helpline: 666 /ASK -FPPC SCHEDULE D Income — Loans (Received or OutstandiyQ) > NAME OF LENDER ADDRESS hh tz,i BUSINESS ACTIVITY OF LENDER D!f Financial Institution IF ❑ Other INTEREST RATE TERM (Months /Years) r `` _% ❑ None j HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 F $ 1 , 001 - $10,000 ❑ $t0,001 — $100,000, OVER $100,000 SECURITY FOR LOAN ` _ F None E] Aulomobile Personal residence Real Properly V 1 10 I J.ral (nr»d eL"t?� 111 p S atltlress cay ❑ Guarantor ❑ Other > NAM OF LENDE k ADDRESS BUS 11JE55 ACTIVITY OF LENDER -E: " F i nancial Institution P n ❑ Other INTEREST RATE TERM (Months /Years) -7.- _7t� ❑ None TS HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 $1,001 - '$10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 SECURITY FOR LOAN �,,,�� - ❑ None g Automobile ❑ Personal residence ❑ Real Property r beer atlEress Ciry ❑ Guarantor ❑ Other (Describe) Comments: NAME OF LENDER _ �,IrtOPo� �tS /iP' ADDRESS fte- NV BUSINESS ACTIVITY OF LENDER M'Financial Institution lll-] Other INTEREST RATE � % ❑ None TERM (Months/Years) HIGHEST BALANCE DURING / REPORTING PERIOD ❑ $500 - $1,000 .. W $1,001 - $10,000 ❑ $10,001 - $100,000 Ej OVER $100,000 SECURITY FOR LOAN lu None ❑ Automobile ❑ Personal residence ❑ Real Property Slreel atlmess ❑ Guarantor ❑ Other (Describe) > NAME OF LENDER TOV018 R iAf C- ADDR �vX 60 11q' 6 try of lmdt1Or / BESS ACTIVITY OF LENDER Financial Institution ❑ Other INTEREST RATE IN n shears) Jr % ❑ None J HIGHEST BALANCE DURING REPORTING PE OD [1 $500 - $1,000 ❑ $1.001 - $10,000 $10,001 - $100,000. ❑ OVER $100,000 SECURITY FOR LOAN ��// E] None I7�I Automobile ❑ Personal residence ❑ Real Property ❑ Guarantor ❑ Other `. FPPC Form 700 (2001/2002) Sch. D FPPC Toll -Free Helpline: 666 /ASK -FPPC