Palacios, Monserrat - 2018-2019 FPPC Form 700STATEMENT OF ECONOMIC INTERESTS Dal�+
FAIR POLITICAL PRACTICES COMMISSION COVER PAGE /C/ITY CLERK'S OFFICE
Please type or print in ink. A PUBLIC DOCUMENT `�/i/7�/oj t�v jZ 3 P.
NAME OF FILER (LAST) (FIRST) (MIDDLE)
Palacios
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
Citv of El Segundo
Monserrat
Division, Board, Department, District, if applicable Your Position
Recreation & Parks Senior Administrative Analyst
► If fling for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency:
2. Jurisdicdon of Office (Check at least one box)
❑ State
❑ Multi -County
❑x City of ElSegundo
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 through
December 31, 2018.
❑ Assuming Office: Date assumed
❑ Candidate: Date of Election
Position:
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Left I
(Check one circle.)
Q The period covered is January 1, 2018, through the date of
-or- leaving office.
Q The period covered is I I through
the date of leaving office.
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 B - Real Property — schedule attached
-or- 0 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)
401 Sheldon St. ElSegundo CA 90814
NUMBER
EMAIL ADDRESS
310 ) 524-2882 1 mpalacios@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 for I Is t d corn
I
Date Signed V� Signatu
(month, day, year) (Filet Signed paper statement with your riling 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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