Tam Chu - Assuming CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS Date Joirial,Eilgg,Flaceived
CITYOFnOSFMEAD
FAIR POLITICAL PRACTICES COMMISSION
A PUBLIC DOCUMENT COVER PAGE
Please type or print in ink
NAME OF FILER (LAST) (FIRST' C11 eninamr.O Lire-Fut:.
N 9Y.
1I rail
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
C-1'7 12-A,‘“)
Division, Board, Department, District, if applicable Your Position
Co \ 4°is 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
EE-City of Peace:-ins rsji- ❑Other
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2016,through ❑ Leaving Office: Date Left I J
December 31, 2016- (Check one)
or-
The period covered is_t_t ,through 0 The period covered is January 1.2018,through the date of
December 31, 2016. or leaving office.
Zi Assuming Office: Date assumed 111 I ml-I b v. O 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) r. Total number of pages including this cover page:
Schedules attached
❑ Schedule A-1 -Investments-schedule attached ❑Schedule C-Income, Loans, & Business Positions-schedule attached
❑ Schedule A-2-Investments-schedule attached ❑Schedule D-Income-Gifts-schedule attached
❑ Schedule B- Real Property-schedule attached ❑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-Public ewumeml
$833 E. Q)c4Ae, BLDict fr.cr,. 'my R.-s< Ca- 4 , -770
DAYTII1E TELEPHONE NUMBER EMAIL ADDRESS
( Why ) StAPC-- DTJ
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 i 0 I Z /r 2 Signature
(oxen day year) (File the originally signed slalemenl wt row ng Onkel)
FPPC Form 700(2016/2017)
FPPC Advice Email:advice@fppc.ca.gov
FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov