John Scott - Annual (Public Works) STATEMENT OF ECONOMIC INTERESTS Date IR�E�I� II� ived
CALIFORNIA FORM 700 CITY"C�r b EAD
FAIR POLITICAL PRACTICES COMMISSION COVER PAGE
JUN 1 8. 2019
Please type or print in ink. A PUBLIC DOCUMENT
CITY cLfinlcc orrlae
NAME OF FILER (LAST) (FIRST) :(MIDDLE)
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1. Office, Agency, or Court
Agency Name (Do not use acronyms)
(;I4y of- IosemeAD P(4,b1,c Woleks Si,pieAdi-f.elide v h
Divisi Bo rd, Department, District, if applicable Your Position
C \J
► 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)
❑State ❑Judge or Court Commissioner(Statewide Jurisdiction)
❑Multi-County p El County of
City of )O5 '� ❑Other
3. Type of Statement (Check at least one box) j�'�j /J�`
Annual: The period covered is January 1, 2018, through 'Leaving Office: Date Left v�`!/ i Z `�
December 31, 2018. (Check one circle.)
-or-
The period covered is l I , through 0 The period covered is January 1, 2018, through the date of
December 31, 2018. -or-leaving office.
❑ Assuming Office: Date assumed I / 0 The period covered is—J I ,through
the date of leaving office.
❑ Candidate: Date of Election and office sought, if different than Part 1:
4. Schedule Summary (must complete) ► Total number of pages including this cover page: _
Schedules attached
❑ Schedule A-1 -Investments–schedule attached ❑Schedule C-Income, Loans, &Business Positions–schedule attached
❑ Schedule A-2- Investments–schedule attached ❑Schedule D- Income– Gifts–schedule attached
❑/Schedule B-Real Property–schedule attached ❑Schedule E-Income– Gifts– Travel Payments–schedule attached
-or- None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Addr ss Recommended-Public Document)
?gar V i-iky Blvd RoseMC•fb OA- - q/7//
DAYTIME TELEPHONE NUMBER EMAIL ADDRESS
) •
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.
45-2s—/ Av. s;t,�
Date Signed � Signature
(month,day y,year) (t=;! .y i d paper statement with your filing official.)
FPPC Form 700(2018/2019)
FPPC Advice Email:advice@fppc.ca.gov
FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov
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