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Sandra Lopez - Annual (Councilmember) CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS Date Initial Filing Received FAIR POLITICAL PRACTICES COMMISSION COVER PAGE Fling Official Use Only A PUBLIC DOCUMENT Filed Date:03/31/2021 01:08 AM SAN:FPPC Please type or print in ink. NAME OF FILER (LAST) (FIRST) (MIDDLE) Lopez Sandra Armenta 1. Office,Agency, or Court Agency Name (Do not use acronyms) City of Rosemead Division,Board,Department,District,if applicable Your Position City Council Member ► If filing for multiple positions,list below or on an attachment. (Do not use acronyms) Agency: SEE ATTACHED LIST 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 ['City of Rosemead ❑Other 3. Type of Statement(Check at least one box) ❑x Annual: The period covered is January 1,2020,through ❑ Leaving Office: Date Left December 31,2020. (Check one circle.) -or- The period covered is ,through 0 The period covered is January 1,MO,through the date of December 31,2029. -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: 3 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- ❑ None-No reportable interests on any schedule 5.Verification MAILING ADDRESS STREET CITY STATE ZIP CODE (Business or Agency Address Recommended-Public Document) 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 true and correct. Date Signed 03/31/2021 01:08 AM Signature (month,day,year) (File the originally signed paper statement with your riling official.) FPPC Form 700-Cover Page(2020/2021) advice@fppc.ca.gov•866-275-3772•www.fppc.ca.gov Page-5 STATEMENT OF ECONOMIC INTERESTS CALIFORNIA FORM 700 COVER PAGE ATTACHMENT FAIR POLITICAL PRACTICES COMMISSION Name Sandra Lopez EXPANDED STATEMENT LIST Agency Name Division,Board, Position or Title Jurisdiction Type of Period Covered Department,District Statement Senate Staff District Representative State Annual 01/01/20-12/31/20 California CALIFORNIA FORM 700 SCHEDULE D FAIR POLITICAL PRACTICES COMMISSION Name Income — Gifts Sandra Lopez ►NAME OF SOURCE(Not an Acronym) ► NAME OF SOURCE(Not an Acronym) Republic Services ADDRESS(Business Address Acceptable) ADDRESS(Business Address Acceptable) 2531 East 67th Street Long Beach,CA 90805 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) 06/ 11 /20 $10.00 Bundt Cake 08/07/20 s 10.00 Lunch 09/23/20 340.06 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) ►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) Comments: FPPC Form 700-Schedule D(2020/2021) advice@fppc.ca.gov•866-275.3772•www.fppc.ca.gov Page-15