Polly Low RECEIVED
. . . "TV O. 'P;59ad}AC
Date Initial Filing Received
CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS
FAIRPOLITICAL PRACTICES COMMISSION CITY CLy2 §OF-ICC
UBLIC DOCUMENT COVER PAGE BY:__ =-_
Please type or print in ink.
NAME OF FILER (LAST) (FIRST) (MIDDLE)
Low Polly
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of Rosemead
Division, Board, Department, District, if applicable Your Position
City Council Council Member
w. 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)
E State ❑Judge or Court Commissioner(Statewide Jurisdiction)
❑Multi-County 0 County of
J City of Rosemead ❑Other
3. Type of Statement (Check at least one box)
lI Annual: The period covered is January 1, 2017,through ❑ Leaving Office: Date Left J�
December 31,2017. (Check one)
-or- O The period covered is January 1, 2017, through the date of
Decovered1is�� , through
December
emtubberr 311,,2017. leaving office.
•or•
D Assuming Office: Date assumed O The period covered is ,through
the date of leaving office.
❑ Candidate: Date of Election and office sought, if different than Part 1:
4. Schedule Summary (must complete) ► Total number of pages including this cover page: —A
—
Schedules attached
❑ Schedule A-1 •Investments-schedule attached ❑Schedule C-Income Loans, 8 Business Positions-schedule attached
❑ Schedule A.2-Investments-schedule attached 0 Schedule D-Income- Gifts-schedule attached
g 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
(Stsmess or Agency Address Recommended-Public Boca-rent)
8836 East Valley Blvd Rosemead CA 91770
DAYTIME TELEPHONE SUNDER E-MAIL 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 document.
I certify under penalty of perjury under the laws of the State of California that the foregoingrsTNe-p d correct.
Date Signed 12/'G+c4 d', 20/k Signature
(menti.wa yea) Idle eongk4Nvgned sutemml vMr wur MM1NN0cal)
FPPC Form 700(2017/2018)
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 COMAnsSION
Interests in Real Property Name
(Including Rental Income)
14 ASSESSORS PARCEL NUMBER OR STREET ADDRESS 14 ASSESSORS PARCEL NUMBER OR STREET ADDRESS
1036 La Presa Ave
CITY CITY
Rosemead
FAIR MARKET VALUE IF APPLICABLE, LIST DATE. FAIR MARKET VALUE IF APPLICABLE,LIST DATE.
fl$2,000-$10,000 07 10 ❑Szoo0-$10,000
❑$10,001 -Si momJ ) 17 J ) 17 ❑$10 pm -$100000 1 ( 17 _/_/ 17
g $100001 -Si 000000 ACQUIRED DISPOSED ❑swam sioo0,000 ACQUIRED DISPOSED
❑Over$1,000.000 ❑ over$1.000,000
NATURE OF INTEREST NATURE OF INTEREST
❑X Ownership/Deed of Trust ❑ Easement 0 Ownership/Deed of Trust ❑Easement
❑ Leasehold ❑ ❑ Leasehold ❑
Y2 remaining Other Yrs.remaining Omer
IF RENTAL PROPERTY GROSS INCOME RECEIVED IF RENTAL PROPERTY GROSS INCOME RECEIVED
❑ so-5499 ❑saw-mem ❑scoot -st0o00 ❑ so-$499 ❑$500-$1000 ❑$10a1 -510.000
❑ 510,001 -swum ❑OVER$100000 ❑ $10,001 -5100000 ❑ OVER 5100000
SOURCES OF RENTAL INCOME If you own a 10% or greater SOURCES OF RENTAL INCOME If you own 8 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(Business Address Acceptable) ADDRESS(Busrness Address Acceptable)
BUSINESS ACTIVITY,IF ANY. OF LENDER BUSINESS ACTIVITY,IF ANY, OF LENDER
INTEREST RATE TERM(Months/Years) INTEREST RATE TERM(Months/Pears)
% ❑ None % ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD HIGHEST BALANCE DURING REPORTING PERIOD
❑ s500-$1000 ❑$+001 -410,000 ❑S500-$1000 ❑$1001 -$10,000
O al 0E01 -$100,000 ❑ OVER $100,000 ❑510.001 -5100000 ❑ OVER 5100000
❑Guarantor,if applicable ❑Guarantor. if applicable
Comments:
FPPC Form 700(2017/2018)Sch.B
FPPC Advice Email:advice@fppc.ca.gov
FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov
CALIFORNIA FORM 700
SCHEDULE D FAIR POLITICAL PRACTICES COMMISSION
Name
Income — Gifts
• NAME OF SOURCE(Not an Acronym) • NAME OF SOURCE(Not an Acronym)
Burke, Williams&Sorensen LLP Athens
ADDRESS(Business Address Acceptable) ADDRESS(Business Address Acceptable)
444 S Flower St#2400, Los Angeles, CA 90071 14048 Valley Blvd, La Puente, CA 91746
BUSINESS ACTIVITY, IF ANY.OF SOURCE BUSINESS ACTIVITY,IF ANY, OF SOURCE
Contract City and League of Cities Conference Contract City and League of Cities Conference
DATE(mm/ddlyy) VALUE DESCRIPTION OF GIFT(S) DATE(mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
OSl 11 l 17 $ $137.26 Dinner OS / 12 / 17 $ 120 Dinner
JJ— $ Jam— $
J_1 s JJ $
• NAME OF SOURCE(Not an Acronym) • NAME OF SOURCE(Not an Acronym)
ADDRESS(Business Address Acceptable) ADDRESS(Business Address Acceptable)
BUSINESS ACTIVITY IF ANY, OF SOURCE BUSINESS ACTIVITY, IF ANY,OF SOURCE
DATE(mmlddlw) VALUE DESCRIPTION OF GIFT(S) DATE(mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
�J— $ Jam— $
_1_1 s _1J— $
_1_1 $ JJ
• NAME OF SOURCE(Not an Acronym) • NAME OF SOURCE(Not an Acronym)
ADDRESS (Business Address Acceptable) ADDRESS(Business Address Acceptable)
BUSINESS ACTIVITY. IF ANY, OF SOURCE BUSINESS ACTIVITY,IF ANY, OF SOURCE
DATE(mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) DATE(mmlddlyy) VALUE DESCRIPTION OF GIFT(S)
J� s _1_1— $
—J— $ _1_1— S
J_ $ JJ $
Comments:
•
FPPC Form 700(2017/2018)Sch.D
FPPC Advice Email:adviceOfppc.ca.gov
FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov