Patrick Piatt RECEIVED
CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS `' YQ§.ROBChurmAD:==
FAIR POLITICAL PRACTICES COMMISSION N FEB 172016
A PUBLIC DOCUMENT COVER PAGE
Please type or print in ink. CITY CLERK'S OFFICE/O.,
NAME OF FILER (LAST) (FIRST) oV—1AIN0ter --
Piatt Patrick
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of Rosemead
Division. Department,District, h applicable Your Position
Community Development Senior Management Analyst
• If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency: Position:
2. Jurisdiction of Office (check at least one box)
D State ❑Judge or Court Commissioner(Statewide Jurisdiction)
❑Multi-County D County of
D city of Rosemead ❑Other
3. Type of Statement (Check at least one box)
O Annual: The period covered is January 1, 2015, through ❑ Leaving Office: Date Left I i
December 31,2015. (Check one)
or-
The period covered is J_/ through 0 The period covered is January 7, 2015, through the date of
December 31.2015. leaving office.
-or-
❑ Assuming Office: Date assumed_JJ O The period covered is i J through
the date of leaving office.
▪ Candidate: Election year and office sought, if different than Pal 1:
w4. Schedule Summary (must complete) ► Total number of pages deluding Mis cover page: 1
Schedules attached
❑ Schedule A-1 •Investments-schedule attached ❑Schedule C•Income, Loans,8 Business PosAions-schedule attached
❑ Schedule A-2•Investments-schedule attached ❑Schedule D•Income-Gilts-schedule attached
❑ Schedule B-Real Property-schedule attached ❑Schedule E•Income-Gifts-Travel Payments-schedule attached
-or--
J)DNone• No reportable interests on any schedule _
5. Verification
MALING ADDRESS STREET CRV STATE 21P CODE
(BuSoness or Agency Address Recommended-Pudic Document
8838 East Valley Boulevard Rosemead CA 91770
DAYTIME TELEPHONE NUMBER E-MAIL ADDRESS
( 626 ) 569-2100
I have used all reasonable dilgence 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 and correct.
Date Signed 2'/�7/� Signaturo-/%.
[^^rvrv�kin day.year !Re/no onWnMN 5Sned sWement with pw 6,09 ofuat
FPPC Form 700(2015/2016)
FPPC Advice Email:advice @fppcca.gov
FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov