Polly LowSTATEMENT OF ECONOMIC INTERESTS
• •
COVER PAGE APR I
Please type or print in ink.
NAME OF FILER (LAST)
- (FIRST) J (L900L A ' f
Low
-
Polly -
1. O Ag ency, or Co
Agency Name
Rosemead City council
Division, Scant, Department, District, 9 applicable
Your Position
City Council Member
► If filing for multiple positions, list below or on an attachment.
Agency:
Position:
2. Jurisdiction of Office (check at least one box)
❑ State
❑ Judge (Statewide Jurisdiction)
❑ Multi-County
❑ County of
® city or Rosemead
❑ Other
3. Type of Statement (check at least one box)
® Annual: The period covered is January 1, 2010, through December 31, ❑ Leaving Office: Date Left
2010. -or-
(Check one)
The period covered is --- J--J, through December 31, O The period covered is January 1, 2010, through the data of
2010.
leaving office.
❑ Assuming Office: Date J J—
O The period covered is J J, through the date
of leaving office.
❑ Candidate: Election Year Office sought, if different than Part 1:
4. Schedule Summary
Check applicable schedules or "None ""
► Total number of pages including this cover page: 2
❑ Schedule A -1 - Investments - schedule attached
❑ Schedule C - Income, Loans, & Business PDsftlens - schedule attached
❑ Schedule A -2 - Investments - schedule attached
❑X Schedule D - Income - Gifts - schedule attached
❑ Schedule e - Reel Properly - schedule attached
❑ Schedule E - Income - Gffts - Travel Payments - schedule attached
-or-
El None - No reportable Interests on any schedule
5. Verification
MAILING ADDRESS STREET
CITY STATE LP CODE
(Business wAgemy Address Rm m vended - Pub& Dacum wQ
1039 La Press Ave
Rosemead CA 91770
DAYTIME TELEPHONE NUMBER
EMAIL ADDRESS
( 626 ) 573 5549
1 have used ail reasonable diligence in preparing this abatement 1 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 trw d corj)ect.
Date Signed y
Signature
IM M, dsY, year)
(File Me odv ned slalem ml Wih yaw Rae OWAA)
FPPC Form 700 (201012011)
FPPC Toll -Free Helpline: 6661275.3772 w .fppc.ca.gov
SCHEDULE D
Income — Gifts
► NAME OF SOURCE
MGM Casino
ADDRESS (Business Address Acceptable)
Las Vegas N V
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /ddtyy) VALUE DESCRIPTION OF GIFT(S)
j _ 13 1 10 $ 168.00 S. Hui Concert Ticket
JJ— s
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd /yy) VALUE DESCRIPTION OF GIFT(S)
JJ_
$
JJ_ �
► NAME OF SOURCE
ADDRESS (Business Address Acceplable)
BUSINESS ACTIVITY, IF ANY OF SOURCE
DATE (mmldd/yy) VALUE DESCRIPTION OF GIFT(S)
JJ_ �
JJ $
JJ— $
Comments:
► NAME OF SOURCE
ADDRESS (BUSlness Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd VALUE DESCRIPTION OF GIFT(S)
JJ_ s
JJ—
JJ_
$
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mmldd/yy) VALUE DESCRIPTION OF GIFT(S)
JJ g
JJ x
JJ_ $
NAME OF SOURCE
ADDRESS ( Busfness Address Ao pfable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /ddtyy) VALUE
JJ— �
JJ— s
DESCRIPTION OF GIFT(S)
FPPC Fom 700 (201012011) Sch. D
FPPC Toll-Free Helpline: 8662763772 w .fppc.ca.gov