David Montgomery-ScottSTATEMENT OF ECONOMIC INTERESTS I —
COVER PAGE
Please type or print in ink.
NAME OF FILER
Montgomery-Scott
David
Date Received` — '— --„_
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1. Office, Agency, or Court
Agency Name
City of Rosemead
Division, Board, Department, District, 'd applicable Your Posifion
Parks & Recreation Parks & Recreation Director
► If filing for multiple positions, list below or on an attachment.
Agency:
Position:
2. Jurisdiction of Office (check at least one box)
❑ Slate
❑ Multi- County
❑x City of Rosemead
❑ Judge or Court Commissioner (Statewide Jurisdiction)
F Cnnnh, of
❑ Other
3. Type of Statement (check at least one box)
❑X Annual: The period covered is January 1, 2011, through
December 31, 2011.
-or-
The pedod covered is through
December 31, 2011.
❑ Assuming Office: Date assumed
❑ Candidate: Election Year
❑ Leaving Office: Dale Left
(Check one)
O The period covered is January 1, 2011, through the date of
leaving office.
O The period covered is —
the date of leaving office.
Office sought, if different than Pad 1:
through
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
► Total number of pages including this cover page.
❑ Schedule C - Income, Loans, & Business Positions- schedule attached
❑ Schedule D - Income - Gifts - schedule attached
❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
-or-
0 None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(BUSness a AgencyAd&ess RPmmrmrnded - PubNc Oacum o
8838 E Valley Blvd. Rosemead CA 91770
( 626 ) 569 -2161
1 have used all reasonable diligence in preparing this statement. I have reviewed this statement
herein and in any attached schedules is true and complete. I acknowledge this is a public do(
I certify under penalty of perjury under the laws of the State of California that ti� !9.rjet
Date Signed February 27, 2012
(.no,, day, Y.)
best of my
contained
FPPC Form 700 (201112012)
866/275 -3772 www.fppc.ca.gov