Qui D. Nguyen - Annual CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS Date ln1Rr UDAMM;
Filing Official Use Only
FAIR POLITICAL PRACTICES COMMISSION COVER PAGE MAR;05 2020
Please type or print in ink. A PUBLIC DOCUMENT CITY CLERK'S OFFICE
BY:
NAME OF FILER (LAST) (FIRST) (MIDDLE)'
NGUYEN QUI DANG
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
CITY OF ROSEMEAD
Division, Board, Department, District, if applicable Your Position
PARK COMMISSION COMMISIONER
► 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)
0 State ❑Judge, Retired Judge, Pro Tern Judge,or Court Commissioner
(Statewide Jurisdiction)
❑Multi-County ❑County of
E City of ROSEMEAD ❑Other
3. Type of Statement (Check at least one box)
❑x Annual: The period covered is January 1, 2019,through 0 Leaving Office: Date Left I I
December 31, 2019. (Check one circle.)
-or-
The period covered is—J—I ,through 0 The period covered is January 1,2019,through the date of
December 31,2019. -or-leaving office.
❑ Assuming Office: Date assumed_J—I 0 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:
Schedules attached
❑x 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
❑x Schedule B-Real Property—schedule attached ❑ Schedule E-Income—Gifts—Travel Payments—schedule attached
-or- 0 None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended-Public Document)
ROSEMEAD CA 91770-1228
DAYTIME TELEPHONE NUMBER EMAIL ADDRESS
(
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 trueandand correct.
Date Signed 03/0 5/2-0 -7 Signature 6{'/ y�c...,y�
(month,day,year) (File the originally signed paper state your61Mgo/ficaL)
FPPC Form 700-Cover Page(2019/2020)
advIce@fppc.ca.gov•866-275-3772•www.fppc.ca.gov
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SCHEDULE A-1 CALIFORNIA FORM 700
Investments FAIR POLITICAL PRACTICES COMMISSION
Stocks, Bonds, and Other Interests Name
(Ownership Interest is Less Than 10%0) Qui Dang Nguyen
Investments must be itemized.
Do not attach brokerage or financial statements.
► NAME OF BUSINESS ENTITY ► NAME OF BUSINESS ENTITY
Microsoft Sprint
GENERAL DESCRIPTION OF THIS BUSINESS GENERAL DESCRIPTION OF THIS BUSINESS
software Telecommunication
FAIR MARKET VALUE FAIR MARKET VALUE
❑$2,000-$10,000 ❑$10,001 -$100,000 ❑$2,000-$10,000 ❑X $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 NATURE OF INVESTMENT
❑X Stock ❑Other ❑X Stock 0 Other
(Describe) (Describe)
O Partnership 0 Income Received of$0-$499 0 Partnership •Income Received of$0-$499
0 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:
_____/_i_19_ _LJ_12. i___.12 —/—/-19—
ACQUIRED
—/-1LACQUIRED DISPOSED ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY ► NAME OF BUSINESS ENTITY
General Electric Bank of America
GENERAL DESCRIPTION OF THIS BUSINESS GENERAL DESCRIPTION OF THIS BUSINESS
Hardware/Aerospace Banking
FAIR MARKET VALUE FAIR MARKET VALUE
❑$2,000-$10,000 ❑X $10,001 -$100,000 0$2,000-$10,000 ❑X $10,001 -$100,000
❑ $100,001 -$1,000,000 ❑Over$1,000,000 0$100,001 -$1,000,000 0 Over$1,000,000
NATURE OF INVESTMENT NATURE OF INVESTMENT
❑X Stock ❑Other X❑ Stock 0 Other
(Describe) (Describe)
❑ Partnership •Income Received of$0-$499 0 Partnership •Income Received of$0-$499
p 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.139_ _/.12. _l—l_19_ _1_1_19_
ACQUIRED DISPOSED ACQUIRED DISPOSED
► NAME OF BUSINESS,.ENTITY ► NAME OF BUSINESS ENTITY
China Mobile Century Link
GENERAL DESCRIPTION OF THIS BUSINESS GENERAL DESCRIPTION OF THIS BUSINESS
Telecommunication Communication
FAIR MARKET VALUE FAIR MARKET VALUE
o $2,000-$10,000 0 $10,001 -$100,000 ❑X $2,000-$10,000 0 $10,001 -$100,000
❑ $100,001 -$1,000,000 ❑Over$1,000,000 ❑$100,001 -$1,000,000 0 Over$1,000,000
NATURE OF INVESTMENT NATURE OF INVESTMENT
❑ Stock ❑Other ❑X Stock 0 Other
(Describe) (Describe)
❑ Partnership •Income Received of$0-$499 ❑ Partnership •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:
ACQUIRED DISPOSED ACQUIRED DISPOSED
Comments:
FPPC Form 700-Schedule A-1(2019/2020)
advIce@fppc.ca.gov•866-275-3772 e www.fppc.ca.gov
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CALIFORNIA FORM 700
SCHEDULE B FAIR POLITICAL PRACTICES COMMISSION
Interests in Real Property Name
(Including Rental Income) Qui Dang Nguyen
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS ► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
CITY CITY
Rosemead ,Rosemead
FAIR MARKET VALUE IF APPLICABLE,LIST DATE: FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000-$10,000 ❑$2,000-$10,000
❑$10,001 -$100,000 _i_d_9-- -J_i_19_ ❑$10,001 -$100,000 --J___/_19_ _i_i
❑X $100,001 -$1,000,000 ACQUIRED DISPOSED tr l$100,001 -$1,000,000 ACQUIRED DISPOSED
❑Over$1,000,000 ❑ Over$1,000,000
NATURE OF INTEREST NATURE OF INTEREST
❑X Ownership/Deed of Trust 0 Easement ❑X Ownership/Deed of Trust 0 Easement
❑ Leasehold 0 0 Leasehold 0
Yrs.remaining Other Yrs.remaining Other
IF RENTAL PROPERTY,GROSS INCOME RECEIVED IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑$0-$499 ❑ $500-$1,000 0$1,001 -$10,000 ❑$0-$499 ❑ $500-$1,000 ❑ $1,001 -$10,000
❑ $10,001 -$100,000 0 OVER$100,000 ❑ $10,001 -$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 - El None
* You are not required to report loans from a commercial lending institution 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*
None None
ADDRESS (Business Address Acceptable) ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER BUSINESS ACTIVITY, IF ANY,OF LENDER
INTEREST RATE TERM (Months/Years) INTEREST RATE TERM(Months/Years)
% ❑ None % ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD HIGHEST BALANCE DURING REPORTING PERIOD
0$500-$1,000 ❑$1,001 -$10,000 ❑ $500-$1,000 0$1,001 -$10,000
❑$10,001 -$100,000 ❑OVER$100,000 ❑$10,001 -$100,000 0 OVER$100,000
❑ Guarantor, if applicable 0 Guarantor, if applicable
Comments:
FPPC Form 700-Schedule B(2019/2020)
advice@fppc.ca.gov•866-275-3772•www.fppc.ca.gov
Page-11