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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-I CALIFORNIAF FARM700 A Ft POLITICAL PRACTICES Investments COMMISSION 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 ❑ $2,000-$10,000 FAIR MARKET VALUE 1 © $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 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) ❑ Stock ❑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 / / 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 ❑ Partnership Q 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 / / 15 / / 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, Drive, RPV, CA 90275 Name Address (Business Address Acceptable) Address (Business Address Acceptable) Check one 0 Trust, go to 2 Check one 0 Business Entity, complete the box, then go to 2 - � 0 Trust,go to 2 ❑ 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: 'e $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 / ❑ $100,001 -$1,000,000 DISPOSED ❑ Over$1,000,000 ❑ $100,001 -$1,000,000 ❑ Over$1,000,000 NATURE OF INVESTMENT PartnershipEl NATURE OF INVESTMENT © Sole Proprietorship l Other ❑ Partnershi P ❑ Sole Proprietorship [3CEO-Owner Other YOUR BUSINESS POSITION YOUR BUSINESS POSITION P. 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA ► 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRORATA SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST) SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST) 0 $0-$499 0$10,001 -$100,000 0$0-$499 El$10,001 -$100,000 ❑ $500-$1,000 0 OVER $100,000 El$1,001 -$10,000 $500-$1,000 0 OVER$100,000 0 $1,001 -$10,000 11tra:t� ;2 r 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF INCOME OF 510,000 OR MORE paste si�eet,t necessary.' INCOME OF $10.000 OR MORE ,Attach a separate sheet If necessary ❑ None or ❑ Names listed below • ❑ None or III Names listed below ► 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR ► 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: ❑ INVESTMENT El REAL PROPERTY 0 INVESTMENT [] 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 Qr City 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 / / 15 / / 15 0$2,000-$10,000 ❑$10,001 -$100,000 / J 15 / / 15 0 $100,001 -$1,000,000 ACQUIRED DISPOSED 0El Over$1,000,000 $100,001 -$1,000,000 ACQUIRED DISPOSED ❑ Over$1,000,000 NATURE OF INTEREST 0 Property Ownership/Deed of Trust NATURE OF INTEREST ❑Stock ❑ Partnership ❑ Property Ownership/Deed of Trust 0 Stock lip Partnership ❑ Leasehold ❑ Other Yrs.remaining 0 Leasehold ❑ Other Yrs.remaining Theck box if additional schedules reporting investments or real property Check box if additioal nal attached ❑ schedules reporting investments or real property are attached Comments: FPPC Form 700(20 15/2016)Sch.A-2 FPPC Advice Email:advice@fppc.ca.gov FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov