Carolyn Chu - Leaving EAD
CALIFORNIA FORM 700 STATEMENT OF ECONOMIC IN i ERESTS Date gni{i t z PM
ived
FAIR POLITICAL PRACTICES COMMISSION
A PUBLIC DOCUMENT COVER PAGE
Please type or print in ink. ism a'CLERK'S OFFICE
NAME OF FILER (LAST) (FIRST) E,._ �
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1. Office, Agency, or Court
Agency Name (Do not use acronyms)
C ( -DI O r— R_os o7 A O
Division, BDepartment, District, if applicable Your Position
Fi -) DCPARz'mcNFrNDPNCE O/ r2Ecic,C
P. 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)
C Slate 0 Judge or Court Commissioner(Statewide Jurisdiction)
❑Multi-County II County of
tyof Lather
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2016, through ky,.,/Leaving Office: Date Left 026
December 31, 2016. (Check one)
or-
The period covered is_/_/ ,through . The period covered is January 1,2016,through the date of
December 31, 2016. Or leaving office.
❑ Assuming Office: Date assumed_/_/ 0 The period covered is J I ,through
the date of leaving office.
❑ Candidate: Election year and office sought, if different than Part 1:
4. Schedule Summary (must complete) up. Total number of pages including this cover page:
Schedules attached
❑ Schedule A-1 -Investments-schedule attached ❑Schedule C -Income, Loans, 8 Business Positions-schedule attached
❑ Schedule A-2-Investments-schedule attached ❑Schedule D-Income- GMs-schedule attached
❑ Schedule B-Real Property-schedule attached Li Schedule E-Income- Gifts- Travel Payments-schedule attached
Notre- No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended-Puhlk Document)
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DAYTIME TELEPHONE NUMBER / EMAIL ADDRESS
(1
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 ( 7 Signature Ok-"c r rO/It Cl?
(month,day,year) (Flk Me ongriaifyigned statement wan your Rog omciao
FPPC Form 700(2016/2017)
FPPC Advice Email:advice@fppc.ca.gov
FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov