McCollum, Melissa - 2019-2020 FPPC Form 700STATEMENT OF ECONOMIC INTERESTS
CALIFORNIA O-
COVER PAGE Jig
Please type or print in ink. A PUBLIC DOCUMENT , -lxv
NAME OF FILER (LAST) (FIRST) �� '( IDDLE)
MCCOLLUM MELISSA LOUISE
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
CITY OF EL SEGUNDO
Division, Board, Department, District, if applicable Your Position
LIBRARY SERVICES DEPARTMENT LIBRARY DIRECTOR
► If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency: 'jO Cam^' CAl1�vIw1A ��rSr(JnR-� C cC 1�F Position: ADMINISTRATIVE COUNClgCW.,-U .1�\(IU.
2. Jurisdiction of Office (Check at least one box)
❑ State
❑x Multi -County LOS ANGELES, VENTURA
❑x City of EL SEGUNDO
❑ Judge, Retired Judge, Pro Tern Judge, or Court Commissioner
(Statewide Jurisdiction)
❑ County of
❑ Other
3. Type of Statement (Check at least one box)
❑X Annual: The period covered is January 1, 2019, through ❑ Leaving Office: Date Left _J_ I
December 31, 2019. (Check one circle.)
-or-
The period covered is i___Jthrough O The period covered is January 1, 2019, through the date of
December 31, 2019. -or- leaving office.
❑ Assuming Office: Date assumed O The period covered is 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: fi
Schedules attached
❑ Schedule A-1 - Investments — schedule attached ❑ Schedule C - Income, Loans, & Business Positions — schedule attached
❑ Schedule A-2 - Investments — schedule attached ❑x Schedule D - Income — Gifts — schedule attached
❑ Schedule B - Real Property — schedule attached ❑ Schedule E - Income — Gifts — Travel Payments — schedule attached
1
-or- ❑ None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
111 WEST MARIPOSA AVENUE EL SEGUNDO CA 90245
DAYTIME TELEPHONE NUMBER EMAIL ADDRESS
( 310 ) 524-2730 1 MMCCOLLUM@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 3/9/20 Signature ijA� w ((�
(month, day, year) (File the originally signed paper statement with your filing official.)
FPPC Form 700 - Cover Page (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
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SCHEDULE D
Income — Gifts Name
MELISSA MCCOLLUM
► NAME OF SOURCE (Not an Acronym)
EL SEGUNDO EDUCATION FOUNDATION
ADDRESS (Business Address Acceptable)
641 SHELDON STREET EL SEGUNDO, CA 90245
BUSINESS ACTIVITY, IF ANY, OF SOURCE
SUPPORT EL SEGUNDO UNIFIED SCHOOL DIST
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
5 10 / 19 $175 GALA TICKET
$
No. NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
$
��- $
$
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
_/--J$
Comments:
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
$
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
FPPC Form 700 -Schedule D(2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
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