Carolyn ChuSTATEMENT OF ECONOMIC
COVER PAGE
Please type or print in ink.
A Public Document
MAR G 4 2
CITIVCLERIWS OFFICE
BY
NAME (LAST)
(FIRST)
(MIDDLE)
DAYTIME TELEPHONE NUMBER
Chu
Carolyn
A
( 626 ) 569 -2120
MAILING ADDRESS STREET
CITY
STATE
ZIP CODE
OPTIONAL: E -MAIL ADDRESS
(Business Address Acceptable)
8838 E. Valley Blvd.
Rosemead,
CA
91770
1 . Office, Agency, or Court
Name of Office, Agency, or Court:
CITY OF ROSEMEAD
Division, Board, District, if applicable:
FINANCE DEPARTMENT
Your Position:
ACCOUNTING MANAGER
► If filing for multiple positions, list additional agency(ies)/
position(s): (Attach a separate sheet if necessary.)
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ County of
® City of ROSEMEAD
❑ Multi- County
❑ Other
3. Type of Statement (Check at least one box)
❑ Assuming Office/Initial Date: __J __J
0 Annual: The period covered is January 1, 2009,
through December 31, 2009.
-or-
0 The period covered is through
December 31, 2009.
❑ Leaving Office Date Left: —J __J
(Check one)
O The period covered is January 1, 2009, through the
date of leaving office.
-or-
0 The period covered is through
the date of leaving office.
❑ Candidate E lection Year:
4. Schedule Summary
► Total number of pages 1
including this cover page:
► Check applicable schedules or "No reportable
interests."
I have disclosed interests on one or more of the
attached schedules:
Schedule A -1 ❑ Yes - schedule attached
Investments (Less than la% ownership)
Schedule A -2 ❑ Yes - schedule attached
Investments (to% or Greater ownership)
Schedule B ❑ Yes - schedule attached
Real Property
Schedule C ❑ Yes - schedule attached
Income, Loans, & Business Positions (imam other than Gifts
and Tmvel Payments)
Schedule D ❑ Yes - schedule attached
Income - Gifts
Schedule E ❑ Yes - schedule attached
Income - Gifts - Travel Payments
-or-
® No reportable interests on any schedule
5. Verification
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 certify under penalty of perjury under the laws of the State
of California that the foregoing is true and correct.
Date Signed March 4, 2010
(month, day, year)
Signature
(File the original d statement with your filing official)
FPPC Form 700 (2009/2010)
FPPC Toll -Free Helptine: 866 /ASK -FPPC www.rppc.ca.gov