Natalie Haworth AnnualRECEIVED
STATEMENT OF ECONOMIC INTERESTS Date n'i^a Fil�mg%NO2d
Use Only
COVER PAGE MAR 2 7 2023
A PUBLIC DOCUMENT
CITY CLERK'S OFFICE
Please type or print in ink. BY:
NAME OF FILER (LAST) (FIRST) (MIDDLE)
Haworth Natalie D.
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of Rosemead
Division, Board, Department, District, if applicable Your Position
City Clerk's Office
Deputy City Clerk
P. If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Multi -County
❑ City of Rosemead
3. Type of Statement (Check at least one box)
■ Annual: The period covered is January 1, 2022, through
December 31, 2022.
-or-
The period covered is --J---J—
December
—J_JDecember 31, 2022.
_._ Assuming Office: Date assumed
J Candidate: Date of Election
Position:
❑ Judge, Retired Judge, Pro Tem Judge, or Court Commissioner
(Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Left ---J----
(Check one circle.)
through ❑ The period covered is January 1, 2022, through the date of
-or-
leaving office.
_ ❑ The period covered is through
the date of leaving office.
and office sought, if different than Part 1:
Schedule Summary (required) ► Total number of pages including this cover page: 1
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- 1m] None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or AgencyAddmss Recommended - Public Document)
8838 E. Valley Blvd. Rosemead CA 91770
( 626 ) 569-2100 1 nhaworth(&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 Signature
(monthday year)
FPPC Form 700 -Cover Page (2022/2023)
advice@fppc.w.gov a 866-275-3772 - www.fppc.ca.gov
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