Lee, Sam - 2017-2018 Form 700STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
Please type or print in ink.
PEOEIVERI i
Official Use On
CITY CLERK'S OFFICE
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NAME OF FILER (LAST) L (FIRST) (MIDDLE)
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1. Office, Agency, or Court
Agency Name (Do not use acronyms)
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Division, Board, Department, District, if applicable Your Position
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► If filing for multiple positions, list below or on an attachment. (Do not dse acronyms)
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ Multi -County ❑ County of
XCity of C1_V4, #J Q0 ❑ Other
3. Type of Statement (Check at least one box)
Annual: The period covered is January 1, 2017, through
December 31, 2017.
-or-
The period covered is I I through
December 31, 2017.
❑ Assuming Office: Date assumed I I
❑ Leaving Office: Date Left __j—_j
(Check one)
O The period covered is January 1, 2017, through the date of
leaving office.
.or-
0 The period covered is I I 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 A-2 - Investments — schedule attached
❑ Schedule B - Real Property — schedule attached
.or -
None - No reportable interests on any schedule
❑ Schedule C - Income, Loans, & Business Positions — schedule attached
❑ Schedule D - Income — Gifts — schedule attached
❑ Schedule E - Income — Gifts — Travel Payments — schedule attached
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
2
DAYTIME TELEPHONE NUMBER I E-MAIL ADDRESS
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I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of
herein and in any attached schedules is true and complete. I acknowledge this is a public document.
I certify under penalty of
per ury under the laws of the State of California that the-foregoln correct.
Date Signed i r _ ignature
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the information
month, day, year) trd the ongmally signed RatwAuLAlh your filing official)
FPPC Form 700(2017/2018)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov