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Jean Scott( 626 ) 569 -2220 1 jeanscott @cityofrosemead.org 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 acknowledge this is a public document. I certify under penalty of perjury under the laws of the State of California that the foregoing is true andyoqucL Date Signed 21`09/2012 Signature (month, day: year) FPPC Form 700 (201112012) FPPC Toll -Free Helpline: 6661275 -3772 www.fppc.ca.gov CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERE TS f [ Date R G ea FAIR POLITICA� PRACTICES COMMISSION 4 PU BLIC D O C UMENT COVER PAGE L Cff ! C -- -! ' -- E k , 01, F_ ICE Please type or print in ink. By NAME OF FILER (LAST) (FIRST) Scott Jean S. 1. Office, Agency, or Court Agency Name City of Rosemead Division, Board, Department, District, if applicable Your Position Pa and Recreation Assistant Parks and Recreation Director ► If fling for multiple positions, list below or on an attachment. Agency: Position: 2. Jurisdiction of Office (check at least one box) ❑ Stale ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ Mufli- County ❑ County of R City of Rosemead ❑ Other 3. Type of Statement (check at least one box) ❑X Annual: The period covered is January 1, 2011, through ❑ Leaving Office: Date Left --- J—/ December 31, 2011. (Check one) -or- The period covered is —/--J , through O The period coverer is January 1, 2011, through the dale of December 31, 2011, leaving office. ❑ Assuming Office: Date assumed —J O The period covered is _ J___J , through the date of leaving office. ❑ Candidate: Election Year Office sought, 4 different than Pad 1: 4. Schedule Summary Check applicable schedules or "Nonce." ► Total number of pages including this cover page: ❑x Schedule A -1 - Investments- schedule attached ❑ Schedule C - Intone, Loans & Business Positions- schedule attached ❑ Schedule A -2 - Investments- schedule attached ❑ Schedule D - Income - Giles - schedule attached ❑ Schedule B - Real Property - schedule attached ❑ Schedule E - Income - Giles - Travel Payments - schedule attached -or- El None - No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET CITY STATE ZIP CODE (flimir saAgmcyAd&/ Recmmmended - Public Dxummo 8838 Vallev Blvd Rosemead CA 91770 ( 626 ) 569 -2220 1 jeanscott @cityofrosemead.org 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 acknowledge this is a public document. I certify under penalty of perjury under the laws of the State of California that the foregoing is true andyoqucL Date Signed 21`09/2012 Signature (month, day: year) FPPC Form 700 (201112012) FPPC Toll -Free Helpline: 6661275 -3772 www.fppc.ca.gov SCHEDULE A -1 Investments Stocks, Bonds, and Other Interests (Ownership Interest is Less Than 10 %) Do not attach brokerage or financial statements. ICMA -RC GENERAL DESCRIPTION OF BUSINESS ACTIVITY Retirement Investment Fund FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑X $100,001 - $1,000,DD0 ❑ Over $1,0D0,000 NATURE OF INVESTMENT ❑ Stock ❑X Other Stock and Bond Funds IDnscnbel ❑ Partnership ® Income Received of $0 - $499 0 Income Received of $500 or More (Report on SchI C) IF APPLICABLE, LIST DATE. J —J 11 —JJ 11 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,D00 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other ( Deschbe) ❑ Partnership O Income Received of $0 - $499 O InI Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: —J--j 11 __j --- J 11 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 ( Descdbe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED Comments: CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION Name Jean S. Scott ENTITY CAL -PERS GENERAL DESCRIPTION OF BUSINESS ACTIVITY California Public Employee Retirement System FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 x❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other Unknown Investments Describe) ❑ Partnership ® Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) 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 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Desc be) ❑ Partnership O Income Received of $0 - $499 0 Income Received of $500 or More (Report on Schevole G) 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 ❑ $100,001 - $1,000,000 ❑ Over $1,D00,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership 0 Income Received of $0 - $499 0 Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE ACQUIRED DISPOSED FPPC Form 700 (201112012) Sch. A -1 FPPC Toll -Free Helpline: 866 /275 -3772 www.fppc.ca.gov