Polly Low - Annual RECEIVED
CITY OFROSEMIEAD
STATEMENT OF ECONOMIC INTERESTS Date Initial Filing Received
CALIFORNIA FORM 700 Filing Official Use Only
COVER PAGE MAR 3 0 RECD
FAIR POLITICAL PRACTICES COMMISSION
Please type or print in ink. A PUBLIC DOCUMENT CITY CLERK'S t�;F,FIC
>3'f:
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
► 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 Tern Judge, or Court Commissioner
(Statewide Jurisdiction)
❑Multi-County ❑County of
❑x City of Rosemead ❑Other
3. Type of Statement (Check at least one box)
❑x 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 ❑x Schedule D-Income—Gifts—schedule attached
❑x 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 Document)
8836 East Valley Blvd Rosemead CA 91770
DAYTIME TELEPHONE NUMBER EMAIL 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 foregoing is tr • and c. rect.
y77).0
Date Signed Signature /
• (month,day,year) (File t r origi.IIy signed paper statement with your filing official.)
FPPC Form 700-Cover Page(2019/2020)
in co P ( advice@fppc.ca.gov•866-275-3772•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)
►
ASSESSORS PARCEL NUMBER OR STREET ADDRESS ► ASSESSOR'S 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:
❑$2,000-$10,000 ❑$2,000-$10,000
❑$10,001-$100,000 -/19 19 ❑$10,001 -$100,000 19 _ _/_/19
$100,001 -$1,000,000 ACQUIRED DISPOSED Li$100,001 -$1,000,000 ACQUIRED DISPOSED
❑ Over$1,000,000 ❑ Over$1,000,000
NATURE OF INTEREST NATURE OF INTEREST
® Ownership/Deed of Trust ❑ Easement ❑ Ownership/Deed of Trust ❑ Easement
❑ Leasehold ❑ ❑ Leasehold ❑ -
Yrs.remaining Other Yrs.remaining Other
IF RENTAL PROPERTY,GROSS INCOME RECEIVED IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑$0-$499 ❑$500-$1,000 ❑$1,001 -$10,000 ❑ $0-$499 ❑$500-$1,000 ❑$1,001 -$10,000
❑$10,001-$100,000 ❑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 ❑ 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*
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
❑$500-$1,000 ❑$1,001 -$10,000 ❑$500-$1,000 ❑ $1,001-$10,000
❑$10,001 -$100,000 ❑ OVER$100,000 ❑$10,001 -$100,000 ❑ OVER$100,000
❑ Guarantor,if applicable ❑ Guarantor,if applicable
Comments:
FPPC Form 700-Schedule 8(2019/2020)
advice@fppc.ca.gov•866-275-3772•www.fppc.ca.gov
Page-11
Y
I
CALIFORNIA FORM 700
SCHEDULE D FAIR POLITICAL PRACTICES COMMISSION
Income — Gifts Name
► NAME OF SOURCE(Not an Acronym) ► NAME OF SOURCE(Not an Acronym)
Burke,Williams&Sorensen LLP
ADDRESS(Business Address Acceptable) ADDRESS(Business Address Acceptable)
444 S Flower St#2400, Los Angeles, CA 90071
BUSINESS ACTIVITY,IF ANY, OF SOURCE BUSINESS ACTIVITY, IF ANY, OF SOURCE
Contract City and League of Cities Conference
DATE(mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) DATE(mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
051619 $139.26 Dinner
$ �� $
► 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�— $
$
—/ $
► NAME OF SOURCE(Not an Acronym) I. 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)
$ �� $
Comments:
FPPC Form 700-Schedule D(2019/2020)
advice@fppc.ca.gov•866-275-3772•www.fppc.ca.gov
Page-15