John ScottSTATEMENT OF ECONOMIC INTER�ST$�� 14J
COVER PAGE
Please type or Pont in ink.
NAME OF FILER (LAST)
(FIRST)
E
Scott
John '
1. Office, Agency, or Court
Agency Name
City ofRosemead
51 Board, Departmont, District, if applicable
Your Position
Public wmUm
Public Services Superintendent
»nmm0mrmo|ilpoPmi0000.no/bwoworon«om\nomnom
Agency:
Ps|Uoo
2. Jurisdiction of office (Check at least one box)
[]mgo
L] Judge o/ Court Commissioner (Statewide JurIsmmmn)
[]Mo|i'0000ty
LJ County v/---_----___�����������������
X City o/ -Rosemead
11 Other
3. Type of Statement (Check at least one box)
O0 Annual: The period covered ix January 1.oxi.through
[] Leaving Office: Date Left
Dowmmo31�xn1
(Check one)
-or-
The period covered*
through O The period covered is January 1, 2011, through [he date of
0000m»v3n,aMi
leaving office.
[l Assuming Office: Date assumed
C The period covered |o through
the date W leaving office
I _.l Candidate: Election Year Office sought, if diKorm(than Part i _--------_ --- _ -- — -
4. Schedule Summary
Check applicable schedules o/"wooa"
li Total number of pages including this cover page: .�.~..~.~.~
[T Schedule x,1- Investments — schedule attached
[] Schedule o- Income, Loans, & Business Positions — schedule attached
[
[]Schedule D-/mx�v—G�/— schedule attached
3y Schedule o- Real Property — ohedo|ouuaoho«
[] Schedule c' Income — Gifts — Travel Payments — schedule attached
-or-
None - No reportable interests on any schedule
S. Verification
MAILING ADDRESS STREET
CITY STATE ZIP CODE
wosum,or/wmrymmmxmwmmode« Park amwnv
035 Butte St.
Claremont CA 91711
909 ) 399-5169
jscott@cityofrosemead.org
ji
| have used all reaso mogeocwmwopunUthis statement | have reviewed [his statement and to the best o[myknowledge the information contained
here and in any allached schedules is true and complete. I acknow this is a public document
| certify under penalty vryedury under the laws of the State o[ California that the fore i t d correct
O3'28'2012
Date Signed mgnumm
FPPC Form mopm1mo4
ppm Toll-Free oo|plim: 866/275-3772 *���.ca.00v
SCHEDULE A -2
Investments, Income, and Assets
of Business Entities /Trusts
(Ownership Interest is 10% or Greater)
Name
Georgia Marie Piskule jrv-c
Address (Business Address Acceptable)
Check one
X. Trust, go to 2 ❑ Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE IF APPLICABLE, LIST DATE_
[� $0 - $1,999
[$2,000 - $10,000 . -- -- )- -J -11- - --J -J - ��
[] $10,001 - $100,000 ACQUIRED DISPOSED
Q $100,001 - $1,000,000
❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Sole Proprietorship ❑ Partnership E]
YOUR BUSINESS POSITION
Omer
0 $0 - $499 L] $10,001 - $100,000
❑ $500 - $1,000 LX] OVER $100,000
❑ $1,001 - si Q000
Check one box_
INVESTMENT ❑X REAL PROPERTY
Name of Business Entity, if Investment, 91
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity or
City or Other Preoise Location of Reel Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
$2,000 - $10,000
❑ $10.001 - $1o0.000 --- -- j-- -j -11- ----- -7---- -J-
[X] $100,001 - $1,000,000 ACQUIRED DISPOSED
[] Over $1,000,000
NATURE OFINTEREST
D Property Ownership/Deed of Trust E] Stock [] Partnership
Name
�CALIFORNIAFORM 700
- FAIk POLI YILAjI. PkACTICE0 U�9MMI601ON
Address (Business Address Acceptable)
Check one
❑ Trust, go to 2 ❑ Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
�] $0 - $1,999
$2,000 - $10,000
❑ $10001 - $100,000 ACQUIRED DISPOSED
[ -] $100,001 - $1,000,000
E Over $1,000,000
NATURE OF INVESTMENT
❑ Sole Proprietorship [_I Partnership E)
YOUR BUSINESS POSITION
P➢R}i
0$0-$499 [] $10,001 - $100,000
n $50D - $1.000 OVER $100,000
[� $1,001 - $10,000
Check one boxy
INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, it Investment, a
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity or
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
[] $2,000 - $10,000
❑ $10,001 - $100,000 _ —)- --J 11--- )-- - � - �� -
EXI $100,001 - $1,000,000 ACQUIRED DISPOSED
[_] Over $1,000,000
NATURE OF INTEREST
R Property Ownership/Deed or Trust [] Stock . 11 Partnership
Leasehold _._. - - - -_, E7 Other ._._.- .- ... ... ....... ... ...-.- prop-- ... - - - - -. ❑ Leasehold El other sale Of residential prOD
Ym. remaining Ye.. remaining
E] Check box K additional schedules reporting investments or real property [] Check box it additional schedules reporting investments or real property
are attached are attached
Comments: sale of 132 Cypress St. Orange CA. commercial property FPPC Form 700 (2011 t2012) Sch. A -2
FPPC Toll-Free Helpline: 666275 -3772 www.fppc.ca.gov