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Chen Lin - Annual RECEIVED STATEMENT OF ECONOMIC INTERESTS Date CEINI(1iR§ MEQ CALIFORNIA FORM 700 Filing 'OffffiicialUse Only • FAIR POLITICAL PRACTICES COMMISSION COVER PAGE - JUN,01 2020 Please type or print in ink. A PUBLIC DOCUMENTUcrrYCLERK'S OFFICE • NAME OF FILER (LAST) e(FI�R(IST)�/� � 1. Office, Agency, or Court Agency Name (Do not u acronyms) Division, Bow, Department, District, if applicable Your Position o'4' _ -i.0 . Pa...145 CA llnwy55t'S Y- ► 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-Count ❑.County of pCity of (��Je-`n' ❑Other 3. Type of Statement (Check at least one box) • tgi.Annual: The period covered is January 1, 2019,through ❑ Leaving Office: Date Left j December 31, 2019. (Check one circle.) -or- The period covered is l,ti 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_ 0 The period covered is—1—J.- ,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- xi None- No reportable interests on any schedule 5. Verification • MAILING ADDRESS STREET CITY STATE ZIP CODE • (Business or Agency Address Recommended-Public Document) c'6'1(3c E.-. V e \--e� 1 •\•I' . Sr-e...twz .c� C--I�-- c\ rt-1 DAYTIME TELEPHONE NUMBER EMAIL ADDRESS • (('p, ) S GC\ '`"2\GU - L' .1h liCf"(. o�fGY�,rwcc-V •C c.- . I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to best of my knowledge the inforr?dtion 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. • may' Date Signed 0(0/O l . 7A?� Signature ' L_ - • m- _ (m nth,day,year) (File the onginallysigned paper statem•m with your filing official.) ' - FPPC Form 700-Cover Page(2019/2020) advice@fppc.ca.gov•866-275-3772•www.fppc.ca.gov Page-5 Instructions Cover Page Enter your name,-mailing address, and daytime telephone • If your agency is a multi-county office, list each county in number in the spaces provided. Because the Form 700 is which your agency has jurisdiction. a public document,you may list your business/office • If your agency is not a state office, court, county office, city address instead of your home address. office, or multi-county office(e.g., school districts, special Part 1. Office,Agency, or Court districts and JPAs), check the"other" box and enter the • Enter the name of the office sought or held, or the agency county or city in which the agency has jurisdiction. or court. Consultants must enter the public agency name Example: rather than their private firm's name. (Examples: State This filer is a member of a water district board with jurisdiction Assembly; Board of Supervisors; Office of the Mayor; in portions of Yuba and Sutter Counties. Department of Finance; Hope County Superior Court) 1.Office,Agency,or Court • Indicate the name of your division, board, or district, if Agency Name(Do naluse acronyms) applicable. (Examples: Division of Waste Management; Feather River Irrigation District u/aidos Board,Department Disbict d applicable Your Poston Board of Accountancy; District 45). Do not use acronyms. N/A Board Member • Enter your position title. (Examples: Director; Chief .Utingfor mite's poseons,Est below monanetlahment(Do not use avmny„o) Counsel; City Council Member; Staff Services Analyst) Age,.N/A Pasoan • If you hold multiple positions(i.e., a city council member 2.Jurisdiction of Office(Check at[east one ba:( who also is a member of a county board or commission), Stade ['Judge or of Court Comm one(Saex de Jurisd tion) ©Mco-000 1 Yuba&Sutter Counties f County of you may be required to file statements with each agency. ['Gay of ❑Other To simplify your filing obligations,you may complete an Part 3. Type of Statement expanded statement. Check at least one box.The period covered by a statement • To do this, enter the name of the other agency(ies) is determined by the type of statement you are filing. If you with which you are required to file and your position are completing a 2019 annual statement, do not change the title(s) in the space provided. Do not use acronyms. pre-printed dates to reflect 2020. Your annual statement is Attach an additional sheet if necessary. Complete used for reporting the previous year's economic interests. one statement covering the disclosure requirements Economic interests for your annual filing covering January 1, for all positions. Each copy must contain an original 2020,through December 31, 2020,will be disclosed on your signature. Therefore, before signing the statement, statement filed in 2021. See Reference Pamphlet, page 4. make a copy for each agency. Sign each copy with an original signature and file with each agency. Combining Statements: Certain types of statements may be If you assume or leave a position after a filing deadline, combined. For example, if you leave office after January 1, you must complete a separate statement. For example, a but before the deadline for filing your annual statement,you city council member who assumes a position with a county may combine your annual and leaving office statements. File special district after the April annual filing deadline must file by the earliest deadline. Consult your filing officer or the a separate assuming office statement. In subsequent years, FPPC. the city council member may expand his or her annual filing to Part 4. Schedule Summary include both positions. • Complete the Schedule Summary after you have reviewed Example: each schedule to determine if you have reportable Brian Bourne is a city council member for the City of Lincoln interests. and a board member for the Camp Far West Irrigation • Enter the total number of completed pages including the District—a multi-county agency that covers Placer and cover page and either check the box for each schedule you Yuba counties. Brian will complete one Form 700 using full use to disclose interests; or if you have nothing to disclose disclosure (as required for the city position)and covering on any schedule, check the"No reportable interests" box. interests in both Placer and Yuba counties (as required for Please do not attach any blank schedules. the multi-county position) and list both positions on the Cover Page. Before signing the statement, Brian will make a copy Part 5. Verification and sign both statements. One statement will be filed with Complete the verification by signing the statement and City of Lincoln and the other will be filed with Camp Far West entering the date signed. All statements must have an original Irrigation District. Both will contain an original signature. "wet"signature or be duly authorized by your filing officer to Part 2. Jurisdiction of Office file electronically under Government Code Section 87500.2. • Check the box indicating the jurisdiction of your agency When you sign your statement,you are stating, under and, if applicable, identify the jurisdiction. Judges,judicial penalty of perjury,that it is true and correct. Only the filer candidates, and court commissioners have statewide has authority to sign the statement. An unsigned statement jurisdiction. All other filers should review the Reference is not considered filed and you may be subject to late filing Pamphlet, page 13,to determine their jurisdiction. penalties. FPPC Form 700-Cover Page(2019/2020) advice@fppc.ca.gov•866-275-3772•www.fppc.ca.gov Page-6