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Janet ChinSTATEMENT OF ECONOMIC 1 . Office, Agency, or Court Name of Office, Agency, or Court: Rosemead Traffic Commission Division, Board, District, if applicable: Your - Position: Traffic Commissioner m 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 ❑ Annual: The period covered is January 1, 2006, through December 31, 2006. -or- 0 The period covered is / /_, through December 31, 2006. ® Leaving Office Date Left: — 07 (Check one) O The period covered is January 1, 2006, through the date of leaving office. -or- 0 The period covered is --J --- J, through the date of leaving office. 4. Schedule Summary Total number of pages Including this cover page: b 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 (10% or greater Ownership) Schedule B ❑ Yes - schedule attached Real Property Schedule C ® Yes - schedule attached Income, Loans, 8 Business Positrons (Income Other than Gifts and Travel Payments) Schedule D ❑ Yes - schedule attached Income - Gifts Schedule E ❑ Yes - schedule attached Income - Travel Payments -or- E] 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 12/02/07 (month, day, year) Signature (File the onglrM signed statement with your filing onnal.) ❑ Candidate FPPC Form 700 (200612007) FPPC Toll -Free Helpline: 666 /ASK -FPPC COVER PAGE DEC 0 4 2007 A Public Document Please type or print in ink NAME (LAST) (FIRST) (MIDDLE) DA`rQME TELEPHONE NU VW Xk BY Chin Janet ) MAILING ADDRESS STREET CITY STATE ZIP CODE OPTIONAL: FAX / E -MAIL ADDRESS (May use business address) 3158 N. Gladys Ave Rosemead CA 91770 1 . Office, Agency, or Court Name of Office, Agency, or Court: Rosemead Traffic Commission Division, Board, District, if applicable: Your - Position: Traffic Commissioner m 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 ❑ Annual: The period covered is January 1, 2006, through December 31, 2006. -or- 0 The period covered is / /_, through December 31, 2006. ® Leaving Office Date Left: — 07 (Check one) O The period covered is January 1, 2006, through the date of leaving office. -or- 0 The period covered is --J --- J, through the date of leaving office. 4. Schedule Summary Total number of pages Including this cover page: b 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 (10% or greater Ownership) Schedule B ❑ Yes - schedule attached Real Property Schedule C ® Yes - schedule attached Income, Loans, 8 Business Positrons (Income Other than Gifts and Travel Payments) Schedule D ❑ Yes - schedule attached Income - Gifts Schedule E ❑ Yes - schedule attached Income - Travel Payments -or- E] 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 12/02/07 (month, day, year) Signature (File the onglrM signed statement with your filing onnal.) ❑ Candidate FPPC Form 700 (200612007) FPPC Toll -Free Helpline: 666 /ASK -FPPC SCHEDULE C Income, Loans & Business Positions Name {Other than Gifts and Travel Payments) 3a, Chin NAME OF SOURCE OF INCOME City of Rosemead ADDRESS 8838 E. Valley Blvd, Rosemead CA 91770 BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION Traffic Commissioner GROSS INCOME RECEIVED ® $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's or registered domestic partner's income ❑ Loan repayment ❑ Sale of (Pw", coq O 4 e1D ) ❑ Commission or ❑.Rental Income, Hsreecft.=eoi8to,0000 . ® Othe Stipend (Descrtbe) NAME OF SOURCE OF INCOME ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's or registered domestic partners income ❑ Loan repayment ❑ Sale of (Prop",, car, bae( eic.) E] Commission or ❑Rental Income, Bslewhmw- a&$io,oWormme ❑ Other 2. LOAN RECEIVE You are not required to report loans from commercial lending institutions, or any indebtedness created as part of a retail installment or credit card transaction, made in the lender's regular course of business on term 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` ADDRESS BUSINESS ACTIVITY, IF ANY, OF LENDER HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 Comments: INTEREST RATE TERM (Months/Years) % ❑ None SECURITY FOR LOAN ❑ None ❑ Personal residence ❑ Real Property SbeEl anNess ❑ Guarantor ❑ Other (Oescrlbe) FPPC Form 700 (200612007) ScK C FPPC Toll -Free Helpline: 066 /ASK -FPPC