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CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS
FAIR e oil Ic AL PRACTICES¢ES COMMISSION CITY CLERK'S OF F ICE
A PUBLIC DOCUMENT COVER PAGE BY _._ --
Please type or pnnt in ink
NAME OF FILER (LAST) (FIRST) (MIDDLE)
Tan Su
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of Rosemead
Division. Board. Department, District, if applicable Your Position
Human Resources Human Resource Manager
N 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)
❑Multi-County ❑County of
Q City of Rosemead ❑Other
3. Type of Statement (Check at least one box)
Z Annual: The period covered is January 1.2015, through ❑ Leaving Office: Date Left_/_/
December 31,2015. (Check one)
or•
The period covered is through 0 The period covered is January 1, 2015, through the date of
December 31.2015 leaving office.
-or-
❑ Assuming Office: Date assumed —J 0 The period covered is J J ,through
the date of leaving office.
❑ Candidate: Election year and office sought, if different than Part 1:
4. Schedule Summary(must complete) e. Total number of pages including this cover page:
Schedules attached
❑ Schedule A-I •Investments-schedule attached ❑Schedule C•Income,Loans, it Business Positions-schedule attached
❑ Schedule A-2•Investments-schedule attached ❑Schedule D-Income-Gifts-schedule attached
%Schedule B•Real Properly-schedule attached 0 Schedule E-Income-Gifts-Travel Payments-schedule attached
-Or-
• None-No reportable interests on any schedule _
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended-Rubin.Document)
8838 East Valley Boulevard Rosemead CA 91770
DAYTIME TELEPHONE NUMBER PAIL ADDRESS
( 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 documen).
I certify under penalty of perjury under the laws of the State of California that the foreg1 • and correct.
Date Signed 211111�✓ Signature r�
mom day year) hale 0e nnpn9ly signed&Mmmnl Rath wwarng ofinau
FPPC Form 700(2015/2016)
FPPC Advice Email:advice @fppc.ca.gov
FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov
•
CALIFORNIA FORM 700
SCHEDULE B FAIR POLITICAL PRACTICES COMMISSION
Interests in Real Property Name
(Including Rental Income) _SJ tat`
l ASSESSOR'S PARCEL • MBER E E
OR ST RE T ADDRESS ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
;407 JJ
CITY
f{ Off/ CITY
FAIR MARKET VALUE IF APPLICABLE.LIST DATE. FAIR MARKET VALUE IF APPLICABLE,LIST DATE:
❑$2,000-vox" ❑$2,000-$10,000
❑mow-$100000 / / 15 / /15 ❑$10,001 -$100000 —/ / 15
j100,001 -si,000,o00 ACQUIRED DISPOSED ❑$IDO001 $1000,000 ACQUIRED DISPOSED
❑over$1 000,000 ❑Over 61,000,000
NATURE OF INTEREST NATURE OF INTEREST
�I Ownership/Deeb of Trust ❑Easement ❑Ownership/Deed of Trust ❑Easement
/❑` Leasehold ❑ ❑ Leasehold ❑
Yrs.remaining Other Yrs.remain mg Other
IF RENTAL PROPERTY,GROSS INCOME RECEIVED IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑so-$ass E]6500-61000 ❑$1,001 -$10,000 ❑so-$ass ❑$500-$+000 ❑$1001 -$IDono
❑$10,001 -$100,000 ❑OVER$100,000 ❑$10001-$100.000 ❑OVER$100.000
SOURCES OF RENTAL INCOME: If you own a 10% Or greater SOURCES OF RENTAL INCOME. If you own a 10% or greater
interest, list the name of each tenant that is a single source of interest, list the name of each tenant that is a single source of
income of$10.000 or more. income of$10,000 or more.
❑None ❑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' NAME OF LENDER*
ADDRESS(Busness Address Acceptable) ADDRESS(Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER BUSINESS ACTIVITY, IF ANY,OF LENDER
INTEREST RATE TERM(MonlhsNears) INTEREST RATE TERM(Months/Years)
% ❑ None
% None
HIGHEST BALANCE DURING REPORTING PERIOD HIGHEST BALANCE DURING REPORTING PERIOD
❑$500-$1000 ❑$1001-$10000 ❑$500-$1000 ❑stool $10,000
$10,001-$100,000 ❑OVER$100,000 ❑110001-$100,000 ❑OVER$100000
❑Guarantor,if applicable ❑ Guarantor,it applicable
Comments:
FPPC Form 700(2015/2016)5th.B
FPPC Advice Email:advice @fppc.ca.gov
FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov