Polly LowIl- _I,..r..
Cl BALI
Date Received
STATEMENT OF ECONOMIC INTERESTS ° "MitR11Lul4
COVER PAGE CRY CLEI OFFICE
Please type or Pont in ink BY:
NAME DF FILER JUST) (FIRST) (MIDDLE)
Low Polly
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
Rosemead City Council
Division, Board, Department, District, if applicable
Vour Position
If filing for multiple positions, list below or on an attachment.
(Do not use acronyms)
Agency. _. _ _.
Position.
2. Jurisdiction of Office (Check at least one box)
State
❑ Judge or Court Commissioner (Statewide Jurisdiction)
O Multi -County _
i] County of
it City of Rosemead
n Other
3. Type of Statement (Check at least one box)
Annual: The period covered Is January 1, 2013, through
❑ Leaving Office: Date Lett I
December 31, 2013.
(Check one)
-or.
The period covered is ��
_., through O The period covered is January 1, 2013, through the date of
December 31, 2013
leaving office.
El Assuming Office: Dale assumed J�
O The period covered is through
the date of leaving office.
O Candidate: Election year and office sought, if different than Part 1=.
4. Schedule Summary
Check applicable schedules or "None. ^
► Total number of pages including this cover page: 2
❑ Schedule A-1 - Investments — Schedule attached
E] Schedule C - Income, Loans, 8 Business Positions — schedule attached
❑ Schedule A -H - Investments — schedule attached
Z Schedule 0 - Income — Gifts — schedule attached
❑ Schedule B - Real Property — schedule attached
❑ Schedule E - Income— Gi@s — Tavel Payments — schedule attached
bM1
i] None - No reportable interests on any schedule
5. Verification
MAILING AD BEESS STREET
CRV STATE ZIP CODE
11 o, Agency Address Re[ammsn. Podk ork—Uh
8838 E. Valley Blvd Rosemead CA 91770
DAYTIME TELEPHONE NUMBER
EMAIL ADDREaS (OPTIONAL)
( 626 ) 664 -2899
1 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.
/� /fir
Data Signed
Signature
�I
/mvdh, MY Mal
eonBmellYebnedselaMntwn pv fitlreolkJe(1
FPPC Form 700 (201312014)
FIN HC Advice Email: advice @fppcca.gov
FPPC Toll -Free Helpline: 866 /275 -3772 www.fppc.cz.gov
SCHEDULE D
Income — Gifts
NAME OF SOURCE (Not an Acmnym)
Burke, Williams & Sorensen LLP
ADURESS (Buslneas Address AcCaptable)
444 S. Flower St. Ste 2400, Los Angeles, CA 90071
BUSINESS ACTIVITY IF ANY OF SOURCE
Contract City and League of Cities Conference
DATE (mMtlClyy) VALUE DESCRIPTION OF GIFT(S)
05117113 $ 109.00 Dinner
09119113 $ 112.83 Dinner
J� E
IP NAME OF SOURCE (Not an Acmnym)
ADDRESS (Business Atltlress Acceptable)
DATE (mmddlyy) VALUE DESCRIPTION OF GIFTR)
__1
JJ E
--]--J $ –
NAME OF SOURCE (Not an Acmnym)
ADDRESS (Business Address AceptabN)
BUSINESS ACTIVITY, IF ANY OF SOURCE
DATE (mnddlyy) VALUE DESCRIPTION OF GIFT(S)
Comments:
CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
H NAME OF SOURCE (Not an Acronym)
American Guangdong Community Association
ADDRESS (Business Aeeress Aonaptame)
5948 Temple City Blvd, Temple City CA 91780
BUSINESS ACTIVITY IF ANY OF SOURCE
Anniversary Banquet
DATE (mmlaelyy) VALUE DESCRIPTION of GIFT(S)
O7 107 ( 13 $ 100.00 Raffle Buddha Statue
H NAME OF SOURCE (Not an Acronym)
ADDRESS (Rumness And— Acceptable)
BUSINESS ACTIVITY, IF ANY OF SOURCE
DATE anar y) VALUE DESCRIPTION OF GIFT(S)
H NAME OF SOURCE (Not an Acmnym)
ADDRESS (BOSineas Atltlress Acceptable)
BUSINESS ACTIVITY. IF ANY, OF SOURCE
DATE (mMOtllyy)
VALUE
DESCRIPTION OF GIFTS)
FPPC Form 700 (2013/2014) Sch. D
FPPC Advice Email: advice @fppr.ca.gov
FPPC Toll -Free Helpline :866 /275 -3772 www.fppc.ca.gov