James Lara - Assuming (Recreation Supervisor) RECEIVED
CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS Datccigri iirj g Aced
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FAIR POLITICAL PRACTICES COMMISSION COVER PAGE JUL 1 5 2019
Please type or print in ink. A PUBLIC DOCUMENT CITY CLERK'S OFFICE
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NAME OF FILER (LAST) (FIRST) (MIDDLE)
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1. Office, Agency, or Court
Agency Name (Do not use acronyms)
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Division, Board, Department, District, if applicable Your Position
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► 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 ❑County of
City of — .Sa.‘1"LA.`1) ❑Other
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2018, through ❑ Leaving Office: Date Left I I
December 31, 2018. (Check one circle.)
-or-
The period covered is J 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 2s/ '7 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 CIN STATE ZIP CODE
(Business or Agency Address Recommended-Public Document)
8838 E. Valley Blvd. Rosemead CA 91770
DAYTIME TELEPHONE NUMBER EMAIL ADDRESS
( 626 )569-2100
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 for s oing is true and correct.
Date Signed 7// //9 Signa 4r
(month,day,year) (File the originally signed paper statement with your Sing 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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