Ben Kim - Annual RECEIVED
CITY OF ROSEMEAD
CALIFORNIA FORM STATEMENT OF ECONOMIC INTERESTS Date Initial Filing Received
700 FitrnfdlAN' 61 020
FAIR POLITICAL PRACTICES COMMISSION COVER PAGE
CITY CLERK'S OFFICE
Please type or print in ink. A PUBLIC DOCUMENT BY:
NAME OF FILER (LAST) (FIRST) (MIDDLE)
Kim Ben
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of Rosemead
Division, Board, Department, District, if applicable Your Position
Administration Assistant City Manager
I. 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, Retired Judge, Pro Tem Judge, or Court Commissioner
(Statewide Jurisdiction)
❑Multi-County ❑County of
Rosemead
x❑City of ❑Other
3. Type of Statement (Check at least one box)
• Annual: The period covered is January 1, 2019, through ❑ Leaving Office: Date Left
December 31, 2019. (Check one circle.)
-or-
The period covered is ,through 0 The period covered is January 1, 2019, through the date of
December 31, 2019. -or-leaving office.
❑ Assuming Office: Date assumed_/_/ 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
❑ 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- i None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended-Public Document)
8838 Valley Blvd. Rosemead CA 91770
DAYTIME TELEPHONE NUMBER EMAIL ADDRESS
( 626 )569-2169 bkim@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 corn-
Date Signed 03/09/2020 Signature
(month,day,year) (File the originally :,41 paper statement with your filing official.)
FPPC Form 700-Cover Page(2019/2020)
advice@fppc.ca.gov•566-275-3772•www.fppc.ca.gov
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