Daniel ScottDate Received
otr�a use only
STATEMENT OF EC IC INTERESTS
A Pub &T. EME
EMEAD
Please type or print in ink
MAR 12 Pool
NAME (LAST) - (FIRST) (MIDDLE) DAYTIME TELEPHONE NUMBER.
Scot
Daniel
LP
(626 ) 913 -1430
OPTIONAL: FAX / E -MAIL ADDRESS
(May be business address) _
17056 Gale Avenue, In dus t ry , C 91745
COVER PAGE
1. Name of Office Sought or Held, Agency or
Court (Provide precise name. Do not use - acronyms.)
City of Rosemead
Division, Board, District, if applicable:
Fire Department
Position:
Assistant Fire Chief
If Expanded Statement - List agency /position:
(Attach a separate sheet if necessary. Do not use acronyms.
File originally signed statement with each filing official.)
Agency:
Position Title:
2. Office Jurisdiction (check one)
State
ELCounty of Los Angeles
❑ City of
❑ Multi -County
❑ Other
3. Type of Statement tCheck at feast one box)
® Assuming Office /Initial- Date: 1 1 1 1 01
❑ Annual
(Check one)
O The period covered is January 1, 2000, through
December 31. 2000.
Q The period covered is
December 31, 2000.
through
❑ Leaving Office Date Left:
(Check one)
• The period covered is January 1, 2000, through the
date of leaving office.
• The period covered is through the
date of leaving office.
❑ Candidate
CITY CLERK'S C4FICE
4. Schedule Summary
(Check applicable schedules 91 'No reportable interests.
-e During the reporting period, did you have any reportable
interests to disclose on:
Schedule A -1 ❑ Yes - schedule attached -
Investments (Less man 10% owrennInp)
Schedule A -2 ❑ Yes - schedule attached
Investments (cramer tnan IoM ownership)
Schedule B ❑ Yes - schedule attached
Real Property -
Schedule C ❑ Yes - schedule attached
Income & Business Positions (income other then 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
ao� ❑ No reportable interests on any schedule
Total number of pages (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.
EXECUTED ON January 5, 2001
(month, day, year)
C
SIGNATURE
._lFti the originally signed staoth ertrwith your filing official)
FPPC Form 700 (200012001)
FPPC Toll -Free Helpllne: 86WASK -FPPC