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CA Form 700 Statement of Economic Interests - Brooks RECEIVED CITY OF RANCHO PALOS VERDE. Date initial Filing Received CALIFORNIA FORM700 STATEMENT OF ECONOMIC INTERESTSlAtfl'16 2016 FAIR POLITICAL PRACTICES COMMISSION A PUBLIC DOCUMENT COVER PAGE Please type or print in ink. CITYCLERKiSOFACE NAME OF FILER (LAST) (FIRST) (MIDDLE) Brooks Susan M 1. Office, Agency, or Court Agency Name (Do not use acronyms) City of Rancho Palos Verdes Division, Board, Department, District, if applicable Your Position City Council/Successor Agency/Improvement Authority Councilwoman/Member ► If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: see Exhibit A Position: 2. Jurisdiction of Office (Check at least one box) ❑State ❑Judge or Court Commissioner(Statewide Jurisdiction) ❑Multi-County ❑County of City of Rancho Palos Verdes ❑Other 3. Type of Statement (Check at least one box) Annual: The period covered is January 1, 2015, through ❑ Leaving Office: Date Left I I December 31, 2015. (Check one) -or- The period covered is I I , through 0 The period covered is January 1, 2015, through the date of December 31, 2015. leaving office. -or- El Assuming Office: Date assumed I I 0 The period covered is I I , through the date of leaving office. ❑ Candidate: Election year and office sought, if different than Part 1: 4. Schedule Summary (must complete) ► Total number of pages including this cover page: -Schedules attached j> 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 r-, Schedule B-Real Property-schedule attached ❑Schedule E-Income- Gifts- Travel Payments-schedule attached "Or" El 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 E-MAIL 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 1 e ^ 01006 Signature (month,day,year) (File the originally signed statement with your filing official.) FPPC Form 700(2015/2016) FPPC Advice Email:advice@fppc.ca.gov FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov Exhibit A 2015 STATEMENT OF ECONOMIC INTERESTS — FORM 700 COVER PAGE ATTACHMENT FOR EXPANDED STATEMENT Councilwoman Susan Brooks Agency: Palos Verdes Transit Authority (Annual) Sanitation Districts (Dist. No. 5 & So. Bay San. Dist.) Position title: Board Member (Annual) SCHEDULE A-1 • CALIFORNIA FORM OMMI��l�N Investments FAIR POLITICAL PRACTICES C Stocks, Bonds, and Other Interests Name (Ownership Interest is Less Than 10%) Do not attach brokerage or financial statements. Susan Brooks ► NAME OF BUSINESS ENTITY I. NAME OF BUSINESS ENTITY Citigroup GENERAL DESCRIPTION OF THIS BUSINESS GENERAL DESCRIPTION OF THIS BUSINESS Banking FAIR MARKET VALUE E] $2,000-$10,000 FAIR MARKET VALUE 1 E $10,001 -$100,000 ❑ $2,000-$10,000 10 0 - ❑ $ 00,001 -$1,000,000 Over$1,000,000 ❑ $ 01 $100,000 ❑ $100,001 -$1,000,000 0 Over$1,000,000 NATURE OF INVESTMENT COII'ltl'lOn & Preferred ❑✓ Stock Other❑ d NATURE OF INVESTMENT (Describe) ❑ Stock El Other ❑ Partnership 0 Income Received of$0-$499 (Describe) ❑ Partnership 0 Income Received of$0-$499 0 Income Received of$500 or More(Report on Schedule C) 0 Income Received of$500 or More(Report on Schedule C) IF APPLICABLE, LIST DATE: IF APPLICABLE, LIST DATE: / / 15 05 / 01 / 15 ACQUIRED DISPOSED / � /— 5— ACQUIRED DISPOSED I. NAME OF BUSINESS ENTITY ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE FAIR MARKET VALUE ❑ $2,000-$10,000 ❑ $10,001 -$100,000 ❑$2,000- $10,000 ❑ $10,001 -$100,000 ❑ $100,001 -$1,000,000 ❑ Over$1,000,000 ❑ 10D 00$ 1 - $1,000,000 Over$1,000,000 NATURE OF INVESTMENT Stock NATURE OF INVESTMENT ❑ ❑Other (Describe) E] Stock ❑Other EIPartnership 0 Income Received of$0-$499 (Describe) ❑ Partnership (]Income Received of$0-$499 0 Income Received of$500 or More(Report on Schedule C) 0 Income Received of$500 or More(Report on Schedule C) IF APPLICABLE, LIST DATE: IF APPLICABLE, LIST DATE: / / 15 / / 15 ACQUIRED DISPOSED / / 15 / �_ ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE FAIR MARKET VALUE ❑ $2,000-$10,000 ❑ $10,001 -$100,000 ❑$2,000- $10,000 ❑ $10,001 -$100,000 ❑ $100,001 -$1,000,000 Over$1,000,000 $100 001 - ❑ $1,000,000 El Over$1,000,000 NATURE OF INVESTMENT ❑ Stock NATURE OF INVESTMENT ❑Other (Describe) ❑ Stock El Other EJPartnership 0 Income Received of$0-$499 (Describe) ❑ Partnership 0 Income Received of$0-$499 0 Income Received of$500 or More(Report on Schedule C) 0 Income Received of$500 or More(Report on Schedule C) IF APPLICABLE, LIST DATE: IF APPLICABLE, LIST DATE: / / 15 / / 15 ACQUIRED DISPOSED / / 5 / / 15 ACQUIRED DISPOSED Comments: FPPC Form 700(2015/2016)Sch.A-1 FPPC Advice Email:advice@fppc.ca.gov FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov . _ SCHEDULE A-2 CALIFORNIA L FORNtA FORM 700 Investments, Income, FAIR POLITICAL PRACTICES COMMISSION and Assets of Business Entities/Trusts Name (Ownership Interest is 10% or Greater) Susan Brooks 1110. 1. BUSINESS ENTITY OR TRUST I. 1. BUSINESS ENTITY OR TRUST Susan Brooks Communications, Inc. Name Name Address (Business Address Acceptable) Address (Business Address Acceptable) Check one 0 Trust, goto 2 Check one 0 Business Entity, complete the box, then go to 2 0 Trust,go to 2 0 Business Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF THIS BUSINESS - v GENERAL DESCRIPTION OF THIS BUSINESS Mediation, Public Relations, Marketing, FAIR MARKET VALUE IF APPLICABLE, LIST DATE: El$0-$1,999 FAIR MARKET VALUE IF APPLICABLE, LIST DATE: Q $2,00001 / 01 / 15 15 ❑ $0-$1,999 , -$10,000 0$10,001 -$100,000 ACQUIRED � / ❑ $2,000-$10,000 / / 15 / 15 DISPOSED 0$10,001 -$100,000 ACQUIRED / 0 $100,001 -$1,000,000 DISPOSED E] Over$1,000,000 ❑ $100,001 -$1,000,000 ❑ Over$1,000,000 NATURE OF INVESTMENT PartnershipEl NATURE OF INVESTMENT © Sole ProprietorshipP Other 0artnershi p ❑ Sole Proprietorship [3 CEO-Owner Other YOUR BUSINESS POSITION YOUR BUSINESS POSITION P. 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA ► 2 IDENTIFY SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST) � THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA � SHARE OF THE GROSS INCOME TO THE ENTlTYil"RUST) 0 $0-$499 0$10,001 -$100,000 ❑ $500-$1,000 0 OVER $100,000 0$0-$499 0$10,001 -$100,000 0 $1,001 -$10,000 0 $500-$1,000 0 OVER$100,000 0 $1,001 -$10,000 11tra:h ;2 r 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF INCOME OF$10,000 OR MORE paste si�eet,t necessary.' INCOME OF 510.000 OR MORE ,Attach a separat?sheet If necessary 0 None or ❑ Names listed below • 0 None or III Names listed below ► 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR ' 1.- 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR LEASED BY THE BUSINESS ENTITY OR TRUST Check one box: LEASED BY THE BUSINESS ENTITY OR TRUST Check one box: 0 INVESTMENT 0 REAL PROPERTY 0 INVESTMENT 0 REAL PROPERTY Name of Business Entity, if Investment,Q Assessor's Parcel Number or Street Address of Real Property Name of Business Entity, if Investment,of p rh' Assessor's Parcel Number or Street Address of Real Property Description of Business Activity pi- City rCity or Other Precise Location of Real Property Description of Business Activity or City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000-$10,000 FAIR MARKET VALUE IF APPLICABLE, LIST DATE: 0 $10,001 -$100,000 J / 15 / / 15 0$2,000-$10,000 0 $100,001 -$1,000,000 ACQUIRED DISPOSED ❑$10,001 -$100,000 / J 15 / / 15 ❑ Over$1,000,000 0$100,001 -$1,000,000 ACQUIRED DISPOSED ❑ Over$1,000,000 NATURE OF INTEREST 0 Property Ownership/Deed of Trust NATURE OF INTEREST ❑Stock El 0 Property Ownership/Deed of Trust 0 Stock lip Partnership ❑ Leasehold ❑ Other Yrs,remaining 0 Leasehold 0 Other Yrs.remaining Theck box if additional schedules reporting investments or real property al re attachedCheck box if 0 additional schedules reporting investments or real property are attached Comments: FPPC Form 700(203.5/2016)Sch.A-2 FPPC Advice Email:advice@fppc.ca.gov FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov