Jeffrey Foutz - AnnualSTATEMENT OF ECONOMIC INTERESTS
COVER PAGE
A PUBLIC DOCUMENT
Please type or print in ink.
1. Office, Aqency, or Court
Agency Name (Do not use acronyms)
City of Rosemead
Division, Board, Deepart�ment, Distdc,toif applicable Your Position
► If filing for multiple positi ns, list below or on an attachment. (Do not use acronyms)
Agency:
2. Jurisdiction of Office (Check at tealt one box)
Ll State
❑ Multi -County
Position:
Date Initial P RIfIfWceived
F1fl19f RCP xwEMEAo
APR u i 2w
El Judge, Refired Judge, Pro Tem Judge, or Court Commissioner
(Statewide Jurisdiction)
❑ County of
❑ City of Rosemead ❑ Other
3. Type of Statement (check at feast one box)
U' Annual: The period covered is January 1, 2022, through J Leaving Office: Dale Left _J— I
December 31, 2022. (Check one circle.)
.or -
The period covered is
December 31, 2022.
,' Assuming Office: Date assumed
Candidate: Date of Election
through LJ The period covered is January 1, 2022, through the dale of
or -
leaving office.
_ IJ The period covered is I I 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:
Schedules attached
J Schedule A-1 - Investments - schedule attached U Schedule C - Income, Loans, & Business Positions - schedule attached
❑ Schedule A-2 - Investments - schedule attached U Schedule D - Income - Gifts - schedule attached
Schedule B - Real Property - schedule attached U Schedule E - Income - Gifts - Travel Payments - schedule attached
-or- � None - No reportable interests on any schedule
S. Verification
MAILING ADDRESS STREET CITY STATE nP Uuuc
(B=ness aAgerr y Address Recommended - Pubhc Documens)
8838 E. Valley Boulevard Rosemead CA 91770
(626 ) 569-2100
1 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 O/ gbz� Signature
—�—(.ay. MI/
FPPC Form 700 - Cover Page (2022/2023)
advice@fppc.w.gov - 866-27S-3772 - v,ww.fppC.ce.gov
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