-- -

011700170-NFH-0170 Date Initial Filing Received

CALIFORNIA FORM 700 STATEMENT OF ECONOMIC IN RESTS Official Use Only

FAIR POll nCAl PRACTICES COMMISSION EmiddotFiled 020712019A PUBLIC DOCUMENT COVER PAGE 182450

Filing 10 176560900Please type or print in ink

NAME OF FILER (LAST) (FIRST] (MIDDLE)

Chambers Thomas R

1 Office Agency or Court Agency Name (Do not use acronyms)

SAN MATEO COUNTY

Division Board Department District if applicable Your Position

Westborough Wa t er District Member

~ If filing for multiple positions list below or on an attachment (Do not use acronyms)

Agency _ _____--_____________ Position __________________

2 Jurisdiction of Office (Check at least one box)

o State o Judge or Court Commissioner (Statewide Jurisdiction)

o MultimiddotCounty ________________ QJCountyof_S_a_n_M_a_t e_o______________

o City of _________________ o Other _________________

3 Type of Statement (Check at least one bOX)

o AnnualThe period covered is January 1 2018 through o Leaving Office Date Left --1--1__ December 31 2018 (Check one circle)

-ormiddot o The period covered is January 1 2018 through the dateThe period covered is--1---1__ through of

December 312018 leaving office

o The period covered is --1--1__ through the dateo Assuming Office Date assumed --1--1__ of leaving office

o CandidateDate 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

[ill Schedule Amiddot1 bull Investments - schedule attached o Schedule C bull Income Loans amp Business Posffions - schedule attached

o Schedule Amiddot2 bull Investments - schedule attached QJ Schedule D bull Income - Gifts - schedule attached

o Schedule B bull Real Property - schedule attached o Schedule E bull Income - Gifts - Travel Payments - schedule attached

-or-

O None - No reportable interests on any schedule

5 Verification MAILING ADDRESS STREET CITY STATE ZIP CODE (Business or Agency Address Recommendedmiddot Public Document)

South San Francisco CA 9408 0 DAYTIME TELEPHONE NUMBER EmiddotMAIL 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 0207201 9 om-as C-hamb=ers-_-_--_-_-c-c--___Signature Thc Ro(month day year) (File theoriginally signed paper slatemenl with your filing official)

FPPC Form 700 (20182019) FPPC Advice Email advicefppccagov

FPPC Toll-Free Helpline 866275-3772 wwwfppccagov

Ol1700~70-NFH-0170

SCHEDULE A-1 Investments

Stocks Bonds and Other Interests (Ownership Interest is Less Than 10)

Investments must be itemized Do not attach brokerage or financial statements

CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION

Name

Chamber s Thoma s R

~ NAME OF BUSINESS ENTITY ~--------------------------------------~ NAME OF BUSINESS ENTITY

Vodafone Group PLC Verizon Communications Inc

GENERAL DESCRIPTION OF THIS BUSINESS GENERAL DESCRIPTION OF THIS BUSINESS

Telecommunications Telecommunications

FAIR MARKET VALUE FAIR MARKET VALUE

o $2000 - $10000 IRl $10001 - $100000 o $2000 - $10000 IRl $10001 - $100000

0$100001 - $1 000000 DOver $1000000 0$100001 - $1000000 o Over $1 000000

NATURE OF INVESTMENTo Stock llil Other _S_t_o_c_k_A_DR_________ NATURE OF INVESTMENT

lliJ Stock 0 Other ------------shy(Describe) (DeSCribe) o Partnership 0 Income Received of $0 - $499 o Partnership 0 Income Received of $0 - $499

o Income Received of $500 or More (Report on Schedule C) o Income Received of $500 or More (Report on Schedule C)

IF APPLICABLE LIST DATE IF APPLICABLE LIST DATE

---l---lJJl ---l---l1ll ---l---l18 ---l---l1ll ACQUIRED DISPOSED ACQUIRED DISPOSED

~ NAME OF BUSINESS ENTITY ~ NAME OF BUSINESS ENTITY

PGampE Corp Alliant Energy Corp

GENERAL DESCRIPTION OF THIS BUSINESS GENERAL DESCRIPTION OF THIS BUSINESS

Energy Utility Energy Utility

FAIR MARKET VALUE FAIR MARKET VALUE

o $2000 - $10000 IRl $10001 - $100000 o $2000 - $10000 o $10001 - $100000

o $100001 - $1 000000 o Over $1000000 IRl $100001 - $1000000 o Over $1000000

NATURE OF INVESTMENT NATURE OF INVESTMENT

lliJ Stock 0 Other ------------shy lliJ Stock 0 Other ------------shy(Describe) (DeSCribe) o Partnership 0 Income Received of $0 - $499 o Partnership 0 Income Received of $0 - $499

o Income Received of $500 or More (Report on Schedule C) o Income Received of $500 or More (Report on Schedule C)

IF APPLICABLE LIST DATE IF APPLICABLE LIST DATE

---l---l~ ---l---l18 ---l---l~ ---l---l18 ACQUIRED DISPOSED 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

10 $2000 - $10000 o $10001 - $100000 o $2000 - $10000 o $10001 - $100000

0$100001 - $1 000000 o Over $1000000 0$100001 - $1000000 o Over $1 000000

NATURE OF INVESTMENT NATURE OF INVESTMENT

o Stock 0 Other ------------shy o Stock 0 Other ------------shy(Describe) (Describe) o Partnership 0 Income Received of $0 - $499 o Partnership 0 Income Received of $0 - $499

o Income Received of $500 or More (Report on Schedule C) o Income Received of $500 or More (Report on Schedule C)

IF APPLICABLE LIST DATE IF APPLICABLE LIST DATE

---l---l~ ---l---l18 ---l---l18 ---l---lJJl ACQUIRED DISPOSED ACQUIRED DISPOSED

Comments _____________________________________________

FPPC Form 700 (20182019) Sch A-1 FPPC Advice Email advicefppccagov

FPPC Toll-Free Helnline 866275-3772 wwwfOOCCIUIOV

011700l70-NFH-0170bull

CALIFORNIA FORM 700 SCHEDULE D

FAIR POLITICAL PRACTICES COMMISSION

Income - Gifts Name

Chambe r s Tho mas R

bull NAME OF SOURCE (Not an Acronym)

Zach Deng

ADDRESS (Business Address Acceptable)

San Franc i sco CA 94 1 32

BUSINESS ACTIVITY IF ANY OF SOURCE

Student Lowell Hig h Sc hoo l

DATE (mmddyy) VALUE DESCRIPTION OF GIFT(S)

__- 0-- Costco Gift Card~1sectJJL $ 50 - 0

--1--1_ $____

--1--1__ $____

bull NAME OF SOURCE (Not an Acronym)

Lowell Soc i a l Committee ADDRESS (Business Address Acceptable)

San Franc isco CA 94 1 32 BUSINESS ACTIVITY IF ANY OF SOURCE

Lowell High School

DATE (mmddyy) VALUE DESCRIPTION OF GIFT(S)Oute r lands gift card for my retirement as teac he r

--1--1_ $ ____

--1--1__ $____

bull NAME OF SOURCE (Not an Acronym)

ADDRESS (Business Address Acceptable)

BUSINESS ACTIVITY IF ANY OF SOURCE

DATE (mmddyy) VALUE DESCRIPTION OF GIFT(S)

--1--1_ $____

--1--1__ $____

--1--1_ $____

bull NAME OF SOURCE (Not an Acronym)

Lowell Alumni Assoc i a ti o n

ADDRESS (Business Address Acceptable)

San Franc i sco CA 94 132

BUSINESS ACTIVITY IF ANY OF SOURCE

Lowe ll High Sc hoo l

DATE (mmlddyy) VALUE DESCRIPTION OF GIFT(S)

Amazon Gi f t Ca rd fo r my Re tirement

--1--1__ $____

bull NAME OF SOURCE (Not an Acronym)

Lowe ll Ma th Depa rtment

ADDRESS (Business Address Acceptable)

Sa n Fr ancisco CA 94 1 32 BUSINESS ACTIVITY IF ANY OF SOURCE

Lowell High Schoo l

DATE (mmlddyy) VALUE DESCRIPTION OF GIFT(S)Restau ran t Giftc ard for r eti rement as Dept Chai r

--1--1_ $____

--1--1__ $____

bull NAME OF SOURCE (Not an Acronym)

ADDRESS (Business Address Acceptable)

BUSINESS ACTIVITY IF ANY OF SOURCE

DATE (mmlddyy) VALUE DESCRIPTION OF GIFT(S)

--1--1_ $____

--1--1_ $____

--1--1__ $____

Comments _________________________________________________________________________________________

FPPC Form 700 (20182019) Sch 0 FPPC Advice Email advicefppccagov

FPPC TolImiddotFree Helpline 866275-3772 wwwfppccagov