Loading...
Su TanSTATEMENT OF ECONOMIC I Please type or print in ink. COVER PAGE A Public Document NAME (LAST) (FIRST) (MIDDLE) DAYTIME TELEPHONE NUMB Tan Su Won ( 626 1569 -2145 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: Your Position: Human Resources 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 feast one box) ❑ Assuming Office /Initial Date: ❑ Annual: The period covered is January 1, 2009, through December 31, 2009. -or- (8) The period covered is 01 J - 0 - 1 — / 09 ,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 Election Year: 4. Schedule Summary ► Total number of pages 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 10% ownership) Schedule A -2 ❑ Yes — schedule attached Investments (to% or Greater Ownership) Schedule B 7X Yes - schedule attached Real Property Schedule C ❑ Yes - schedule attached Income, Loans, & Business Positions (Inmme Omer than Gifts and Travel payments) Schedule D ❑ Yes - schedule attached Income - Gifts Schedule E ❑ Yes - schedule attached Income - Gifts - Travel Payments OKCial Use Onry f;AR a 4 2p±0 UTI" (- 0V -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. 1 certify under penally of perjury under the laws of the State of California that the foregoing is true and correct. Date Signed 3/3/2010 tooth, day, year) Signature (File the originally signed slafem of wrm your tiling official.) FPPC Form 700 (200912010) FPPC Toll -Free Helpline: 866 1ASK -FPPC www.fppc.ca.gov SCHEDULE B Interests in Real Property (Including Rental Income) ► STREET ADDRESS OR PRECISE LOCATION 3403 Ivar Avenue CITY Rosemead FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 ❑ $10,0ol - sloo,000 ® $100,001 - $1,000,000 ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OF INTEREST 0 Ownership /Deed of Trust ❑ Easement ❑ Leasehold ❑ Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $o - $ass ❑ $500 - $1,000 ❑ $1,001 - $10=0 ❑ $10,om - sloo,coo ❑ OVER $100,000 SOURCES OF RENTAL INCOME: If you own a 10% of greater interest, list the name of each tenant that is a single source of income of $10,000 or more. ► STREET ADDRESS OR PRECISE LOCATION CITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100.000 ❑ $10o,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INTEREST ❑ Ownership /Deed of Trust ❑ Leasehold IF APPLICABLE, LIST DATE: __j_/ 09 _/__j 09 ACQUIRED DISPOSED ❑ Easement Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $409 ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100.000 ❑ OVER $100.000 SOURCES OF RENTAL INCOME: If you own a 10% or greater interest, list the name of each tenant that is a single source of income of $10,000 Or more. II You are not required to report loans from commercial lending institutions made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows: NAME OF LENDER' NAME OF LENDER" ADDRESS (Business Address Acceptable) ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER BUSINESS ACTIVITY, IF ANY, OF LENDER INTEREST RATE TERM (Months/Years) % ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 ❑ Guarantor, if applicable Comments: INTEREST RATE TERM (Months/Years) % ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 ❑ Guarantor, if applicable FPPC Form 700 (200912010) Sch. B FPPC Toll -Free Helpline: 866 /ASK -FPPC www.fppc.ca.gov