Matt HawkesworthPlease type or print in ink.
Hawkesworth
1. Office, Agency, or Court
(LAST)
rE' 1 1. 2412
CITY "S OFFICE
Agency Name
City o Rosemead
Division, Board, Department, District, if applicable
Adminitration
STATEMENT OF ECONOMIC INTERES
COVER PAGE
(FIRST)
Matthew
Your Position
Assistant City Manager
► If filing for multiple positions, list below or on an attachment.
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Multi- County
❑Q City of Rosemead
❑ County of
❑ Other
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2011, through
December 31, 2011.
.or.
The period covered is I I through
December 31, 2011.
❑ Assuming Office: Date assumed
❑ Candidate: Election Year
❑ Leaving Office: Date Left I I
(Check one)
O The period covered is January 1, 2011, through the date of
leaving office.
O The period covered is I I through
the date of leaving office.
Office sought, if different than Part 1:
4. Schedule Summary
Check applicable schedules or "None."
❑ Schedule A -1 - Investments
- schedule attached
❑ Schedule A -2 - Investments
- schedule attached
❑ Schedule B - Real Property
- schedule attached
❑ Schedule C - Income, Loans, & Business Positions - schedule attached
❑ Schedule D - Income - Gifts - schedule attached
❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
.or-
None - No reportable interests on any schedule
5. Verifi
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public DocumenQ
8838 Valley Blvd. Rosemead CA 91770
( 626 ) 569 -2107 I mhawkesworth @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 and correct.
Date Signed 02/13/2012
❑ Judge or Court Commissioner (Statewide Jurisdiction)
► Total number of pages including this cover page:
FPPC Form 700 (201112012)
FPPC Toll -Free Helpline: 866 /275 -3772 www.fppc.ca.gov