Ruiz, Tatiana - 2018-2019 FPPC Form 700STATEMENT OF ECONOMIC INTERESTS RECEIV95
POLITICALFAIR COVER PAGE CITY CLERK'S OFFICE
Please type or print in Ink. A PUBLIC DOCUMENT " 71 sJ Z� l� j; Z ff�e17
NAME OF FILER (LAST) (FIRST) (MIDDLE)
Ruiz Tatiana I
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of El Segundo
Division, Board, Department, District, if applicable
Planning and Building Safety
Your Position
License and Permit Specialist 1
► 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
❑ Multi -County
❑x City of El Segundo
3. Type of Statement (Check at least one box)
❑x Annual: The period covered is January 1, 2018, through
December 31, 2018.
.or -
The period covered is 11 113 I 2018 , through
December 31, 2018.
❑ Assuming Office: Date assumed
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Left
(Check one circle.)
Q The period covered is January 1, 2018, through the date of
-or- leaving office.
0 The period covered is I 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 A-2 - Investments - schedule attached
❑ Schedule 8 - Real Property - schedule attached
-or- ❑x None - No reportable interests on any schedule
❑ Schedule C - Income, Loans, & Business Positions - schedule attached
❑ Schedule D - Income - Gifts - schedule attached
❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
5. Verification
MAILING ADDRESS STREET CITY STATE zip CODE
(Business or Agency Address Recommended - Public Document)
350 Main Street ElSegundo CA 90245
DAYTIME TELEPHONE NUMBER I EMAIL ADDRESS
( 310 ) 524-2380 truiz@elsegundo.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
(month, day, year) ik the originally signed p stsfemenl with your filing official.)
FPPC Form 700(2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPCToII-Free Helpllne: 866/275-3772 www.fppc.ca.gov
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