Clark annaulSTATEMENT OF ECONOMIC INTERESTS Date InjpotfiWMReceived
e a COVER PAGE CIT96' Pgt66W
A PUBLIC DOCUMENT
Please type or print in ink. elTvn =CK"WIN
NAME OF FILER (LAST) (FIRST) (MIDDLE) BY.
Clark Margaret F.
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of Rosemead
Division, Board, Department, Distnd, if applicable Your Position
City Council
Council Member
► If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency:
Los Angeles and San Gabriel Rivers and Mountains Boardmember
Position:
2. Jurisdiction of Office (Check at least one box)
x State
❑ Multi -County
❑ City of Rosemead
3. Type of Statement (check at feast one box)
0 Annual: The period covered is January 1, 2022, through
December 31, 2022.
-or-
The period covered is—�
December 31, 2022.
❑ Assuming Office: Date assumed
❑ Candidate: Date of Election
❑ Judge, Refired Judge, Pro Tem Judge, or Court Commissioner
(Statewide Jurisdiction)
❑ County of CA
❑ Other
❑ Leaving Office: Date Left _J I
(Check one circle.)
through ❑ The period covered is January 1, 2022, through the date of
leaving office.
•or•
_ ❑ The period covered is I I through
the date of leaving office.
and office sought, if different than Pan 1:
Schedule Summary (required) ► Total number of pages including this cover page: y
Schedules attached
❑ Schedule A-1 - Investments – schedule attached ❑o Schedule C - Income, Loans, & Business Positions – schedule attached
❑ Schedule A-2 - Investments – schedule attached ❑E 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
(easiness or Agency Address Recommended - Public Document)
Rosemead
CA 91770
(
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 -7e-y.,4& 2 3 Signature
)
FPPC Form 700 - Cover Page (2022/2023)
advice@fppc.ca.gov • 866-2753772 • www.fppc.ca.gov
Page - 5
r)
SCHEDULE S
Interests in Real Property
(Including Rental Income)
P. ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
3111 Prospect Ave Rosemead Ca 91770
Cm
FAIR MARKET VALUE
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
NATURE OF INTEREST
® OwnershlptDead of Trust
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
❑ Easement
❑ Leasehold 1:1Vre. remaining
Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $499 ❑ $500 - $1,000 ® $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater
interest, list the name of each tenant that is a single source of
income of $10,000 or more.
[]None Steven and Stephanie Valdez
Name
Margaret Clark
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
CITY
FAIR MARKET VALUE
$2,000 - $10,000
$10,001 - $100,000
$100,001 - $1,000,000
Over $1,000,000
NATURE OFINTEREST
❑ Ownership/Deed of Trust
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
❑ Easement
❑ Leasehold ❑
Yrs. re alning
Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000
❑$10,001-$100,000 []OVER $100,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater
interest, list the name of each tenant that is a single source of
income of $10,000 or more.
[]None
' You are not required to report loans from a commercial lending institutions 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'
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
INTEREST RATE TERM (Months/Years)
% ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 []OVER $100,000
❑ Guarantor, it applicable
Comments
NAME OF LENDER'
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
INTEREST RATE
❑ None
TERM (Months/Ysars)
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
❑ Guarantor, if applicable
FPPC Form 700 -Schedule B (202212023)
advicelilfppcca.gov• 000.2753772•w ..fppcm.gov
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOME
James Clark
ADDRESS (Business Address Acceptable)
P.O. Box 86546 Los Angeles Ca 90012
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Milo F. Jamison Bible Fellowship, Inc
YOUR BUSINESS POSITION
President
GROSS INCOME RECEIVED ❑ No Income- Business Position Only
❑ $500 - $1,000 ❑ $1,001 - $10,000
® $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
® Salary ® Spouse's or registered domestic partner's income
(For self-employed use Schedule A-2.)
❑ Partnership (Less than 10% ownership. For 10% or greater use
Schdule A-2.)
❑ Sale of
(Reel MopeM car, Doer, etc.)
❑ Loan repayment
❑ Commission or []Rental Income, t>st each source or $io,000 or more
(Descdbe)
❑ Other rr]exr )
Name
NAME OF SOURCE OF INCOME
Margaret Clark
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
❑ Salary ❑ Spouse's or registered domestic partner's Income
(For selfcmployed use Schedule A-2.)
❑ Partnership (Less than 10% ownership. For 10% orgreater use
Schdule A-2.)
❑ Sale of
(Realpraperty, car, boar. etc.)
❑ Loan repayment
❑ Commission or [-]Rental Income, list each source o/$1e00o or mora
❑ Other
(De be)
2,LOAN RECEIVED OR OUTSTANDING DURING ]HE REPORTING PEPIOD I
* You are not required to report loans from a commercial lending institution, or any indebtedness created as part
of a retail installment or credit card transaction, 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`
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000
❑ $1,0o1 - $10,000
❑ $10,001 - $100,000
❑ OVER $100,000
LL .,r
INTEREST RATE TERM (MonthslYears)
% ❑ None
SECURITY FOR LOAN
❑ None ❑ Personal residence
❑ Real Property
❑ Guarantor
❑ Other (Deswibe)
FPPC Farm 700 -Schedule C (2022!2023)
adviceftpc.ca.gav • 00&275.3772 • w .rppe.ce.gcv
ell
SCHEDULE D
Income- Gifts
► NAME OF SOURCE(Not an Acronyml
city of Rosemead
ADDRESS (Business Address Acceptable)
8838 E.Valley Blvd Rosemead CA 91770
BUSINESS ACTIVITY, IF ANY, OF SOURCE
-DATE (mnVddtyy) VALUE DESCRIPTION OF GIFT(S)
12/15/2022 s 125 Prize drawing visa gift card
s
a
► NAME OF SOURCE (Not an Acronym)
Henry Xie
ADDRESS (Business Address Acceptable)
Grand Inn 1000 S. Euclid St. Fullerton CA 92832
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mnVdtlryy) VALUE DESCRIPTION OF GIFT(S)
12/16/2022 $ 150 Christmas gift cards Macy's
s
$
P. NAME OF SOURCE Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY IF ANY, OF SOURCE
DATE (mmlddtyy) VALUE DESCRIPTION OF GIFT(S)
S
S
$
Comments:
I Margaret Clark
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd1yy) VALUE DESCRIPTION OF GIFT(S)
s
S
s
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE -
DATE (mMtldlyy) VALUE DESCRIPTION OF GIFT(S)
s
$
a
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
$
3
S
FPPC Form 700 • Schedule D (202=23) .
29 iCe@rppC.Cagoe• 086-2753772• w Jppace.gov _