Jean Hall,+
STATEMENT OF ECONOMIC INTERESTS Date Received
• ' • ' at Hoot Received
FAIR POLITICAL PUBLIC - DOCUMENT COVER PAGE
Please type or print in ink.
NAME OF FILER (LAST) (FIRST) (MIDDLE)
Hall Jean
1. Office, Agency, or Court
Agency Name
City of Rosemead
Division, Board, Department, District, if applicable Your Position
Traffic Commission
► If filing for multiple positions, list below or on an attachment.
Agency:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Multi- County
❑x City of Rosemead
3. Type of Statement (Check at least one box)
❑
x Annual: The period covered is January 1, 201L through
December 31, 207-
-or-
The period covered is through
December 31, 2011.
❑ Assuming Office: Date assumed
❑ Candidate: Election Year
Traffic Commissioner
Position:
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Leff __J__J
(Check one)
O The period covered is January 1, 2011, through the date of
leaving office.
O The period covered is through
the date of leaving office.
Office sought, if different than Pad 1:
4. Schedule Summary
Check applicable schedules or "None." ► Total number of pages including this cover page:
Schedule A -1 - Investments- schedule attached ❑ Schedule C - Income, Loans, & Business Positions- schedule attached
Schedule A -2 - Investments- schedule attached Schedule 0 - Income - Gifts - schedule attached
Ly schedule B - Real Property - schedule attached ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
❑ None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
/Business aAgencyAddress Recommended- Public Oxumeno .
8838 E. Valley Boulevard
( 626 ) 569 -2100
Rosemead
CA 91770
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.
j Date Signed 3 -az, / i3
/maim. dayyead
FPPC Form 700 (2011/2012)
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov
SCHEDULE A -1 1 9. , 8
Investments
Stocks, Bonds, and Other Interests Name �I
(Ownership Interest is Less Than 10 %) �� �� ' Z c�
Do not attach brokerage or financial statements.
UESS ENTITY
► NAME OF BSIN
J�'A\/
'
I �C'S4L /WIGS
GENERAL DESCRIPTION OF BUSINESS ACTIV�
GDS
FAIR MARKET VALUE
$2,000 - $10,000 ❑ $10,001 - $100000
.r❑
prt 8100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other
(Deuribe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Repay on schedule o)
IF APPLICABLE, LIST DATE:
_IJ 12 JJ 12
ACQUIRED DISPOSED
► NA OF BUSINESS ENTITY
GENERAL DESCRIPTIO OF BUSINESS ACTIVITY
FAIR MARKET VALUE
82,000 - $10,000 ❑ $10,001 - 8700.000
8100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other
(Desvibe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Sched ✓le c)
IF APPLICABLE, LIST DATE:
_J-J_l?_ JJ 12
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE
❑ $2,000 - $10.000 ❑ Smoot - $100.000
❑ $to0,001 - $1,000,90o ❑ Over $1.000.000
NATURE OF INVESTMENT
❑ Stock ❑ Other
(Dexrihe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Repot as schedule C)
IF APPLICABLE, LIST DATE:
? JJ 12
ACQUIRED DISPOSED
Comments:
► N/A�E OF BUSINESS ENTITY /1
GENE
DESCRIPTION OF BUSINESS ACTIVITY
C°1�s
FAIR MARKET VALUE
❑ $2.000 - $10,000 ❑ $10,001 - $100,000
%$100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stack ❑ Other
(DexriEe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE. LIST DATE:
JJ 12 JJ 12
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
(Deuribel
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Repot on Schedule C)
IF APPLICABLE, LIST DATE:
lJ 12 .JJ 12
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
(Dexri�e)
❑ Partnership O Income Received of $0 - $499
O Income Received of S500 or More (Repot on schedule c)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
FPPC Form 700 (2012/2013) Sch. A -1
FPPC Advice Email: ac1vice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275 -3772 vaww.fppc.ca.gov
SCHEDULE A -2 CALIFORNIA FORM
FAIR POLITICAL PRACTICES COMMISSION
Investments, Income, and Assets
Name e
of Business Entities /Trusts Jct -aZ�
(Ownership Interest is 10% or Greater)
go to 2 ❑ Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ SO - $1,999
❑ $2,000 - $10.000
__j__/–L2 __jJ 12
$10,001 - $100,000
ACQUIRED DISPOSED
$100,001 - $1,000,000
Over $1.000,000
_ /_/ 12
NATURE OF INVESTMENT
❑ Partnership ❑ Sole Proprietorship
YOUR BUSINESS POSITION
❑ $0 - $499
❑ $500 - $1,000
❑ $1,001� - $10,000
tI75TiT`TariTaLir
None
❑ $10,001 - $100.000
OVER $100,000
r ,.
Check one box:
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment X
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity a
City or Other Precise Location of Real Property
FAIR MARKET VALUE
❑ $2,000 - $10,000
❑ $10,001 - $100,060
❑ $100,001 . $1,000,000
❑ Over $1,000,000
NATURE OF INTEREST
❑ Property Ownership/Oeed of Trust
IF APPLICABLE, LIST DATE:
_/_/ 12 _/_/ 12
ACQUIRED DISPOSED
❑ Stack ❑ Partnership
❑ Leasehold ❑ Other
Yes. remaini g
❑ Check box if additional schedules reporting investments or real property
are attached
Address (Business Address Acceptable)
Check one
❑ Trust, go to 2 ❑ Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF BUSINESS ACTIVITY
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ $0 - $1,999
❑ $2,006 - $10,000
J—/ 12 _j—J-12
$10,001 - $100,000
ACQUIRED DISPOSED
$100,001 - $1,000,000
Over $1,000,000
_ /_/ 12
NATURE OF INVESTMENT
❑ Partnership ❑ Sole Proprietorship ❑
YOUR BUSINESS POSITION
❑ $0 - $499
❑ $500 - $1,000
❑ $1,001 - $10.000
None
❑ $10,001 - $100,000
❑ OVER $100,000
[]INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment. fu
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity or
City or Other Precise Location of Real Property
FAIR MARKET VALUE I
IF APPLICABLE, LIST D
DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000 _
_ /_/ 12
❑ $100,001 - $1,000,000 A
ACQUIRED D
DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
❑ Property Ownership/Deed of Trust ❑
❑ Stock ❑
❑ Partnership
Leasehold ❑ Other
Yes. remaining
❑ Check box if additional schedules reporting investments or real property
are attached .
FPPC Forth 700 (2012/2013) Sch. A -2
Comments: FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov
SCHEDULE B
Interests in Real Property
(Including Rental Income)
ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
CITY
S�mFna
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
❑ Ownership(Deed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remaining
Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 $100,000, [-1 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.
❑ None
Name
ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
CITY
C4
FAIR MARKET VALUE
IF, APPLICABLE, LIST DATE:
E] $2,000 - $10,000
qd
/ z96 / /_1L
[] $10,001 - $100,000
_ - -
Z$100,001 - $1,000,000
ACQUIRED DISPOSED
❑Over $1,000,000
NATURE OF INTEREST
❑ OwnershiprDeed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remainiig
Omer
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $499 ❑ $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.
❑ None
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'
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
INTEREST RATE TERM (Months/Years)
% ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $1Q001 - $100,000 ❑ OVER $100,000
❑ Guarantor, if applicable
Comments:
NAME OF LENDER'
ADDRESS (Business Address Acceptable)
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
FPPC Form 700 (2012/2013) Sch. B
FPPC Advice Email: advice @fppc.ca.gov,
FPPC Toll -Free Helpline: 866 /275 -3772 www.fppc.ca.gov
SCHEDULE D
Income — Gifts
► NAME OF SOURCE r
CPV f�Lzc rSPoSAL Co
ADDRESS (Business Address Acceptable) {{bU 7+S
:" , y Ez,EC.e! pe /
BUSINESS ACTIVITY, IF ANY OF SOURCE 4-AKl;�-R SAf'T
(✓ a612� (n° o 6ALL -r,G/{C7 r
DATE (m /dd /yy) VALUE DESCRIPTION OF GIFT(S)
__J__J_ 8
___J --- J—
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mnVddlyy) 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($)
Comments:
I Name / /
✓C�,�/ /� �iA &L-
NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm /dd /yy) VALUE
$
Jam_ $
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)
T
��— 8
► NAME OF SOURCE
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY OF SOURCE
DATE (mm/dd /yy) VALUE DESCRIPTION OF GIFT(S)
—/_ s
— /_�— $
FPPC Form 700 (2011/2012) SCh. D
FPPC Toll -Free Helpline: 866 /275 -3772 w fppc.ca.gov