Steven Lym
STATEMENT OF ECONOMIC
= • • COVER PAGE -`
Please type or print in ink.
NAME OF FILER (LAST) (FIRST) l (MIDDLE)
Ly Steven CfT Y CLE RK'S
1. Office, Agency, or Court I �Y_._._ -_--
Agency Name
City of Rosemead Community Development Commission Commissioner
Division, Board, Department, District, if applicable Your Position
► If filing for multiple positions, list below or on an attachment.
Agency:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Multi- County
[] City of Rosemead
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
3. Type of Statement (Check at feast one box)
❑ Annual: The period covered is January 1, 2011, through I?J Leaving Office: Date Left —0 2012
December 31, 2011. (Check one)
-or.
The period covered is through- O The period covered is January 1, 2011, through the date of
December 31, 2011. leaving office.
❑ Assuming Office: Date assumed 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: 5
❑X Schedule A -1 - Investments - schedule attached ❑X Schedule C - Income, Loans, & Business Positions - schedule attached
[] Schedule A -2 - Investments - schedule attached R Schedule D - Income - Gifts - schedule attached
❑ Schedule B - Real Property - schedule attached - ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
-or-
El None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CRY . STATE ZIP CODE
(Business or Agency Address Recommended - Public DocumenQ
8838 E. Vallev Boulevard Rosemead CA 91770
626 ) 569 -2170
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 docum t
I certify under penalty of perjury under the laws of the State of California that the f go s true and correct.
Date Signed 3/13/12 Signature
(monPo, day, year) (File the angina'lyagned statement Wh yaw Poing oMdal)
FPPC Forth 700 (2011/2012)
FPPC Toll -Free Helpline: 866 /275 -3772 w .fppc.ca.gov
SCHEDULE A -1 rName
Investments
Stocks, Bonds, and Other Interests (Ownership Interest is Less Than 10 %)
Do not attach brokerage or financial statements.
► NAME OF BUSINESS ENTITY
Union Pacific Corporation
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
Commercial Rail Services
FAIR MARKET VALUE
❑X $2,000 - $10,000 ❑ $10,001 - $10o,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
XJ Stock ❑ Other
( Descnbe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
International Business Machines Inc
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
Business Technologies and Consulting
FAIR MARKET VALUE
0 $2,000 - $10,000 ❑ $10.001 - $100,000
❑ $100,001 - $1,0o0,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑X Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE
❑ $2,000 - $10,000 ❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More ( Repod on Schedule C)
IF APPLICABLE, LIST DATE:
J —1 11 �J 11
ACQUIRED DISPOSED
Comments:
► NAME OF BUSINESS ENTITY
Walmart Stores Inc
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
General Merchandise Stores
FAIR MARKET VALUE
❑X $2,000- $10,000 ❑$10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
X❑ Stock ❑ Other
Inscribe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schetlute C)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
Quest Diagnostics Inc
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
Medical Supplies
FAIR MARKET VALUE
❑X $2,000 - $10.000 ❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑X Stock ❑ Other
cascdbe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE
❑ $2,000 - $10.000 ❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other
cosrAbe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
FPPC Form 700 (2 0 1112 0 1 2) Sch. A -1
FPPC Toll -Free Helpline: 8661275 -3772 w .fppc.ca.gov
SCHEDULE A -2
Investments, Income, and Assets
of Business Entities/Trusts
(Ownership Interest is 10% or Greater)
LBL Holding LLC
Name
Address (Business Address Acceptable)
Check one
❑ Trust, go to 2 x❑ Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
Real Estate Investment and Management
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $0 - $1,999
❑ $2,000 - $10,000 _lJ 11 JJ 11
❑ $10,001 - $100,000 ACQUIRED DISPOSED
❑ $100,001 - $1,000,000
❑X Over $1,000,000
NATURE OF INVESTMENT
❑ Sole Proprietorship ❑ Partnership ❑X LLC
Other
YOUR BUSINESS POSITION Managinq Partner
❑ $0 - $499 X❑ $10,001 - $100,000
❑ s500 - $1,000 ❑ OVER $100,000
❑ $1,001 - $10,000
Rental Income from 5631 Aldama St and 3450 E 8th St
Los Angeles
Check one box:
❑ INVESTMENT ❑X REAL PROPERTY
LBL Holding LLC
Name of Business Entity, if Investment, or
Assessor's Parcel Number or Street Address of Real Property
Real Estate Investment and Management
Description of Business Activity or
City or Other Precise Location of Real Property
FAIR MARKET VALUE
❑ $2,000 - $10,000
❑ $10,001 - $100,000
❑ $100,001 - $1,000,000
Q Over $1,000,000
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
NATURE OF INTEREST
❑ Property Ownership /Deed of Trust
❑ Leasehold ❑ Other
Yrs. remaining
❑ Stock ❑X Partnership
❑ Check box if additional schedules reporting investments or real property
are attached
Comments
Name
Steven Ly
San Gabriel Valley Business Journal LLC
Name
Address (Business Address Acceptable)
Check one
❑ Trust, go to 2 I] Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
News Publication
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $0 - $1,999
❑ $2,000 - $10,000
Q $10,001 - $100,000 ACQUIRED DISPOSED
❑ $100,001 - $1,000,000
❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Sole Proprietorship ❑ Partnership ❑X LLC
Other
YOUR BUSINESS POSITION Publisher
❑ $0 - $499 ❑ $10,001 - $100,000
❑ $500 - $1,000 ❑ OVER $100,000
❑ $1,001 - $10,b00
Check one box:
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, a
Assessors Parcel Number or Street Address of Real Property
Description of Business Activity gi
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000
❑ $100,001 -$1,000,000 ACQUIRED DISPOSED
❑ Over $1,000.000
NATURE OF INTEREST
❑ Property Ownership /Deed of Trust ❑ Stock ❑ Partnership
❑ Leasehold ❑ Other
Yrs. remaining
❑ Check box if _additional schedules reporting investments or real property
are attached
FPPC Form 700 (20112012) Sch. A -2
FPPC Toll -Free Helpline: 866 /275 -3772 w .fppc.ca.gov
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOME
Regional Chamber of Commerce San Gabriel Valley
ADDRESS (Business Address Acceptable)
19720 E Walnut Dr. South, Suite 201, Walnut CA
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Business Association
YOUR BUSINESS POSITION
Chief Executive Officer
GROSS INCOME RECEIVED
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑X $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
0 Salary ❑ Spouse's or registered domestic partners income
❑ Loan repayment ❑ Partnership
❑ Sale of
(Reel P-Periy, .,,, boat, etc.)
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
❑ Other
(Describe)
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS. POSITION
GROSS INCOME RECEIVED
❑ $500 - $1000 ❑ $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 ❑ Partnership
❑ Sale of
(Real property, car, boar, etc.)
❑ Commission or ❑ Rental Income, list each source of S10,000 or more
❑ Other
(Describe)
LOANS r OR OUTSTANDING DURING THE REPORTING PERIOD
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 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'
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
INTEREST RATE TERM (Months/Yeam)
% ❑ None
❑ Real Property
srrael address
SECURITY FOR LOAN
❑ None ❑ Personal residence
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000
❑ $1,001 - $10,000
❑ $10,001 - $100,000
❑ OVER $100,000
Comments:
Gty
❑ Guarantor
❑ Other
(Describe)
FPPC Form 700 (2011/2012) Sch. C
FPPC Toll -Free Helpline: 866 /275 -3772 w yfppc.ca.gov
SCHEDULE D
7s e
Income —Gifts
en
► NAME OF SOURCE
Southern California Edison
ADDRESS (Business Address Acceptable)
2244 Walnut Grove Ave, Rosemead CA
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Energy Producer and Supplier
DATE (mMdd /yy) VALUE DESCRIPTION OF GIFT(S)
08 1 17 / 11 e 405 Tour of Big Creek SCE
facilities and energy
conveyance system
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd /yy) VALUE DESCRIPTION OF GIFT(S)
� J— $
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd /yy) VALUE
$
—J -- S
��— $
DESCRIPTION OF GIFT(S)
Comments:
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd /yy) VALUE
�— — $
��— $
_/ --- / $
DESCRIPTION OF GIFT(S)
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd /yy) VALUE DESCRIPTION OF GIFT(S)
$
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE -
DATE (mMdd /yy) VALUE
$
—/— $
DESCRIPTION OF GIFT(S)
FPPC Form 700 (20112012) Sch. D
FPPC ToII -Free Helpline :866 /275 -3772 w ..fppc.ca.gov
MAYOR:
STEVEN LY
MAYOR PRO TEM:
SANDRA ARMENTA
COUNCIL MEMBERS:
BILL ALARCON
MARGARET CLARK
POLLY LOW
March 14, 2012
Secretary of State
Political Reform Division
1500 11' Street, Room 495
Sacramento, CA 95814
To Whom It May Concern:
i cy f osemcad
8838 E. VALLEY BOULEVARD • P.O. BOX 399
ROSEMEAD, CALIFORNIA 91770
TELEPHONE (626) 569 -2100
FAX (626) 307 -9218
Enclosed, is an original 700 Statement of Economic Interest for leaving office of
Rosemead's Redevelopment Agency. If there are any questions, please feel free to
contact the office of the City Clerk at (626)569 -2177. Thank You.
Sincerely,
Ericka Hernandez
Assistant to the City Clerk
Enclosure: Steven Ly's 700
Rachel Richman's 700
CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS Date Received
FAIR POLITICAL PRACTICES COMMISSION
A PUBLIC DOCUMENT COVER PAGE 1A K 2111
Please type or print in ink. - - - -- . --
NAME OF FILER (LAST) MRST) -- - -- - - _ (MIDDLE)
Ly Steven
1. Office, Agency, or Court
Agency Name
C of Rosemead
Division, Board, Department, District, If applicable Your Position
City Council Councilman
► If filing for multiple positions, list below or on an attachment.
Agency:
Position:
2. Jurisdiction of Office (check at least one box)
❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ Multi - County
❑x City of Rosemead
❑ County of
❑ Other
3. Type of Statement (check at least one box)
❑x Annual: The period covered is January 1, 2011, through
December 31, 2011.
-or-
The period covered is I I through
December 31, 2011.
❑ Assuming Office: Date assumed
❑ Candidate: Election Year
❑ Leaving Office: Date Left ___J__J
(Check one)
O The period covered is January 1, 2011, through the date of
leaving office.
O The period covered is —
the date of leaving office.
through
Office sought, if different than Part 1:
4. Schedule Summary
Check applicable schedules or "None."
0 Schedule A -1 - Investments - schedule attached
0 Schedule A -2 - Investments - schedule attached
❑ Schedule B - Real Property- schedule attached
❑X Schedule C - Income, Loans, & Business Positions- schedule attached
❑X Schedule D - Income - Gifts - schedule attached
❑ Schedule E - Income - Gifts - Travel Payments- schedule attached
-or-
El None - No reportable interests on any schedule
5. V eri fi cation
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business wAgencyAddress Recommended - P blx Oxumem)
8388 E Valley Blvd Rosemead CA 91770
DAYTIME TELEPHONE NUMBER E -MAIL ADDRESS (OPTIONAL)
( 626 ) 569 -2100
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 1/5/2012 Signature AEE�::�
(mwlh, day year) L' = aginabysr'W staow[ -#h Ya ffbgorrx -O
► Total number of pages including this cover page: 5
FPPC Form 700 (2011/2012)
FPPC Toll -Free Helpline: 666 1275 -3772 www.fppc.ca.gov
SCHEDULE A -1
Investments
Stocks, Bonds, and Other Interests
(Ownership Interest is Less Than 10 %)
Do not attach brokerage or financial statements.
► NAME OF BUSINESS ENTITY
Union Pacific Corporation
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
Commercial Rail Services
FAIR MARKET VALUE
❑X $2,000 - $10,000 ❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑X Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
International Business Machines Inc
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
Business Technologies and Consulting
FAIR MARKET VALUE
❑X $2,000 - $10,000 ❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
0 Stock ❑ Other
( Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule Q
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE
❑ $2,000 - $10,000 ❑ $1a 001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
Comments:
Walmart Stores Inc
CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
General Merchandise Stores
FAIR MARKET VALUE
❑X $2,000 - $10,000 ❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑X Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on schedule C)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
Quest Diagnostics Inc
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
Medical Supplies
FAIR MARKET VALUE
❑X $2,000 - $10.000 ❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT -
❑X Stock ❑ Other
(Descnba)
❑ Partnership O Incorpe Received of $0 - $499
O Income Received of $500 or More (Report on schedule C)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE
❑ $2,000 - $10,000 ❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
FPPC Form 700 (2011/2012) Sch. A -1
FPPC Toll -Free Helpline: 8661275 -3772 vn Jppc.ca.gov
SCHEDULE A -2
Investments, Income, and Assets
of Business Entities /Trusts
(Ownership Interest is 10% or Greater)
LBL Holding LLC
Name
Address (Business Address Acceptable)
Check one
❑ Trust. go to 2 xQ Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
Real Estate Investment and Management
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $0 - $1,999
❑ $2,000 - $10,000
❑ $10,001 - $100,000 ACQUIRED DISPOSED
❑ $100,001 - $1,OOQ000
OX Over $1,000,000
NATURE OF INVESTMENT
❑ Sole Proprietorship ❑ Partnership ❑X LLC
Other
BUSINESS POSITION Managing Partner
❑ $0 -$499 X❑ $10,001 - $100,000
❑ $500 - $1,000 ❑ OVER $100.000
❑ $1,001 - $10,000
Rental Income from 5631 Aldama St and 3450 E 8th St
Los Angeles
Check one box:
❑ INVESTMENT ❑X REAL PROPERTY
LBL Holding LLC
Name of Business Entity, if Investment, or
Assessor's Parcel Number or Street Address of Real Property
Real Estate Investment and Management
Description of Business Activity gr
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ACQUIRED DISPOSED
❑X Over $1,000,000
NATURE OF INTEREST
❑ Property Ownership/Deed of Trust ❑ Stock Q Partnership
❑ Leasehold E] Other
m remaining
❑ Check box if additional schedules reporting investments or real property
are attached
San Gabriel Valley Business Journal LLC
Name
Address (Business Address Acceptable)
Check one
❑ Trust, go to 2 xQ Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
News Publication
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ $o - $1,999
❑ $2,000 - $10,000
JJ 11 _/J 11
0$10001- $100000
ACQUIRED DISPOSED
❑ $100,001 - $1,000,000
❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Sole Proprietorship ❑ Partnership F LLC
Other
BUSINESS POSITION Publisher
❑ $0 - $499 ❑ $10001 - $100,000
❑ $500 - $1,000 ❑ OVER $100,000
❑ $1,001 - $10,000
ll� 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HEL B Y
BUSINESS ENTITY O R TRUST
Check one box:
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, 9 Investment, or
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity 91
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $10o00o
❑ $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OFINTEREST
❑ Property Ownership /Deed of Trust ❑ Stock ❑ Partnership
❑ Leasehold ❑ Other
yrs, remaining
❑ Check box if additional schedules reporting investments or real property
are attached
FPPC Farm 700 (2011 /2012) Sch. A -2
FPPC Toll -Free Helpline: 866 /275 -3772 vvwvv.fppc.ca.gov
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOME
Regional Chamber of Commerce San Gabriel Valley
ADDRESS (Business Address Acceptable)
19720 E Walnut Dr. South, Suite 201, Walnut CA
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Business Association
YOUR BUSINESS POSITION
Chief Executive Officer
GROSS INCOME RECEIVED
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑X $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
❑K Salary ❑ Spouse's or registered domestic partner's income
❑ Loan repayment ❑ Partnership
❑ Sale of
(Real property, car, bowl, etc.)
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
❑ Other
(Dascdba)
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED
❑ $500 - $1,000 ❑ $1001 - $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 ❑ Partnership
❑ Sale of
(Real property, car, boat, etc.)
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
❑ Other
( Descnbe)
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 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`
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
INTEREST RATE TERM (Months/Yeam)
❑ None
SECURITY FOR LOAN
❑ None ❑ Personal residence
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000
❑ $1,001 - $10,000
❑ $10,001 - $100,000
❑ OVER $100,000
Comments:
❑ Real Property
Slreel address
Cdy
❑ Guarantor
❑ Other
(Describe)
FPPC Form 700 (2 0 1112 0 1 2) Sch. C
FPPC Toll -Free Helpline: 8661275 -3772 w Jppc.ca.gov
SCHEDULE D
Income — Gifts
► NAME OF SOURCE
Southern California Edison
ADDRESS (Business Address Acceptable)
2244 Walnut Grove Ave, Rosemead CA
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Energy Producer and Supplier
DATE (mm/dd /yy) VALUE DESCRIPTION OF GIFT(S)
08j_1 7 / 11 $ 405 Tour of Big Creek SCE
$ facilities and energy
% conveyance system
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd /yy) VALUE
$
$
DESCRIPTION OF GIFT(S)
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mmlddlyy) VALUE
$
DESCRIPTION OF GIFT(S)
Comments:
Name
Steven
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE
$
$
— — $
DESCRIPTION OF GIFT(S)
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd/yy) VALUE DESCRIPTION OF GIFT(S)
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd /yy) VALUE
$
$
$
DESCRIPTION OF GIFT(S)
FPPC Form 700 (2011/2012) Sch. D
FPPC Toll -Free Helpline: 866/275 -3772 w fppc.ca.gov
MAYOR:
Steven Ly
MAYOR PRO TEM:
Sandra Annenta
COUNCIL MEMBERS:
William Alarcon
Margaret Clark
Polly Low
February 28, 2012
Secretary of State
Political Reform Division
1500 11th Street, Room 495
Sacramento, CA 95814
To Whom It May Concern:
City o f W9semead
8838 E. VALLEY BOULEVARD P.O BOX 399
ROSEMEAD, CALIFORNIA 91770
TELEPHONE (626) 569 -2100
FAX (626) 307 -9218
Enclosed, is an original 700 form and its copy from Rosemead Council Member Steven Ly. If there
are any questions, please feel free to contact the office of the City Clerk at (626)569 -2171. Thank
You.
Sincerely,
Ericka Hernandez
Assistant to the City Clerk