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Steven Ly - Annual RECEIVED CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS DYrQFaRl3iSffl�teived Official Use Only FAIR POLITICAL PRACTICES COMMISSION COVER PAGE APR 01 2019 Please type or print in ink. A PUBLIC DOCUMENT CITY CLERK'S OFFICE BY• NAME OF FILER (LAST) (FIRST) (MIDDLt) Ly Steven 1. Office, Agency, or Court Agency Name (Do not use acronyms) City of Rosemead • Division, Board, Department, District, if applicable Your Position City Councilman ► 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 0 Judge or Court Commissioner(Statewide Jurisdiction) ElMulti-County0County of Los Angeles g City of Rosemead 0 Other 3. Type of Statement (Check at least one box) ❑x Annual: The period covered is January 1, 2018, through 0 Leaving Office: Date Left I—1 December 31, 2018. (Check one circle.) -or- The period covered is , through 0 The period covered is January 1, 2018, through the date of December 31, 2018. -or-leaving office. ❑ Assuming Office: Date assumed 0 The period covered is I I , 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: 3 Schedules attached ❑x Schedule A-1 -Investments—schedule attached ❑Schedule C-Income, Loans, &Business Positions—schedule attached ❑ Schedule A-2-Investments—schedule attached ❑x Schedule D-Income— Gifts—schedule attached ❑ Schedule B-Real Property—schedule attached ❑Schedule E-Income—Gifts— Travel Payments—schedule attached -or- El None - No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET CITY STATE ZIP CODE (Business or Agency Address Recommended-Public Document) 8838 E Valley Blvd Rosemead CA 91770 DAYTIME TELEPHONE NUMBER EMAIL ADDRESS ( sly@cityofrosemead.org 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 03! '3-10 ` (t Signature `ws4`4.„ (month,day,year) (File the originally sign paper statement with your filing official.) FPPC Form 700(2018/2019) FPPC Advice Email:advice@fppc.ca.gov FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov Page-5 SCHEDULE A-'I CALIFORNIA FORM 700 Investments FAIR POLITICAL PRACTICES COMMISSION Stocks, Bonds, and Other Interests Name (Ownership Interest is Less Than 10%) Steven Ly Investments must be itemized. Do not attach brokerage or financial statements. P. NAME OF BUSINESS ENTITY ► NAME OF BUSINESS ENTITY LBL Holding LLC GENERAL DESCRIPTION OF THIS BUSINESS GENERAL DESCRIPTION OF THIS BUSINESS Real Estate FAIR MARKET VALUE FAIR MARKET VALUE 0 $2,000-$10,000 ❑$10,001 -$100,000 0 $2,000-$10,000 0 $10,001 -$100,000 ❑X $100,001 -$1,000,000 ❑ Over$1,000,000 ❑$100,001 -$1,000,000 0 Over$1,000,000 NATURE OF INVESTMENT Rental NATURE OF INVESTMENT ❑ Stock ❑Other ❑ Stock ❑Other (Describe) Describe) ❑X Partnership 0 Income Received of$0-$499 0 Partnership 0 Income Received of$0-$499 o Income Received of$500 or More(Report on Schedule C) 0 Income Received of$500 or More(Report on Schedule C) IF APPLICABLE, LIST DATE: IF APPLICABLE, LIST DATE: _—l—JAL J LiL —J-118 _J- 1_1$_ ACQUIRED DISPOSED ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY I. NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE FAIR MARKET VALUE 0 $2,000-$10,000 0 $10,001 -$100,000 0 $2,000-$10,000 0 $10,001 -$100,000 ❑ $100,001 -$1,000,000 ❑ Over$1,000,000 ❑ $100,001 -$1,000,000 ❑ Over$1,000,000 NATURE OF INVESTMENT NATURE OF INVESTMENT ❑ Stock ❑Other ❑ Stock ❑Other (Describe) (Describe) ❑ Partnership 0 Income Received of$0-$499 ❑ Partnership 0 Income Received of$0-$499 Q Income Received of$500 or More(Report on Schedule C) 0 Income Received of$500 or More(Report on Schedule C) IF APPLICABLE, LIST DATE: IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED ACQUIRED DISPOSED I. NAME OF BUSINESS ENTITY O. NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE FAIR MARKET VALUE 0 $2,000-$10,000 0$10,001 -$100,000 0$2,000-$10,000 0 $10,001 -$100,000 ❑ $100,001 -$1,000,000 ❑ Over$1,000,000 ❑$100,001 -$1,000,000 ❑ Over$1,000,000 NATURE OF INVESTMENT NATURE OF INVESTMENT ❑ Stock ❑Other ❑ Stock ❑Other (Describe) (Describe) ❑ Partnership 0 Income Received of$0-$499 ❑ Partnership 0 Income Received of$0-$499 O Income Received of$500 or More(Report on Schedule C) 0 Income Received of$500 or More(Report on Schedule C) IF APPLICABLE, LIST DATE: IF APPLICABLE, LIST DATE: —1—Ji —J—JJL .—J—liL _i_____/A8_ ACQUIRED DISPOSED ACQUIRED DISPOSED Comments: FPPC Form 700(2018/2019) FPPC Advice Email:advice@fppc.ca.gov FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov Page-7 CALIFORNIA FORM 700 SCHEDULE D FAIR POLITICAL PRACTICES COMMISSION Name Income — Gifts Steven Ly ► NAME OF SOURCE(Not an Acronym) ► NAME OF SOURCE (Not an Acronym) Republic Services Interwest Services ADDRESS(Business Address Acceptable) ADDRESS (Business Address Acceptable) 18500 N Allied Way, Phoenix, AZ 85054 1500 S Haven Ave, Suite 220, Ontario, CA 91761 BUSINESS ACTIVITY, IF ANY,OF SOURCE BUSINESS ACTIVITY, IF ANY, OF SOURCE Waste Disposal Municipal Consulting DATE(mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) DATE(mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) 05 / 23 / 18 $250 Dodgers Tickets 05 21 / 18 $150 Dinner, ICSC _J—J— $ JJ— $ J—J $ _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 (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) —J_J_ $ —J— $ _1__J $ _J_J— $ J_1 $ __I_J_ $ ► 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(mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) J_/____ $ _JJ— $ _/____/_ $ —___J— $ _/_____I_____ $ ____I_J_ $ Comments: FPPC Form 700(2018/2019) FPPC Advice Email:advice@fppc.ca.gov FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov Page-15