700: Triplett - 2016 from 01/01 - 12/31CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
A PUBLIC DOCUMENT
Please type or print in ink.
RECEIVED
STATEMENT OF ECONOMIC INTERES`S FEB 2 `<.2Ot.
COVER PAGE
CITY OF LA QUINTA
CITY CLERK DEPARTMENT
NAME OF FILER (LAST)
Triplett
(FIRST)
Alcadia
(MIDDLE)
Mae
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of La Quinta
Division, Board, Department, District, if applicable
Community Resources I,epartment,
Your Position
Human Resources Analyst
► If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency: Position.
2. Jurisdiction of Office (Checkat least one box)
❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ Multi -County ❑ County of
❑ Other
City of La Quinta
3. Type of Statement (Check at least one box)
❑x Annual: The period covered is January 1, 2016, through ❑ Leaving Office: Date Left
December 31, 2016. (Check one)
-or-
The period covered is —J_J through
December 31, 2016.
❑ Assuming Office: Date assumed J_J
❑ Candidate: Election year
Q The period covered is January 1, 2016, through the date of
leaving office.
-or-
O The period covered is —J / , through
the date of leaving office.
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
pusi ess or Ag ncy Address Recomm ocument) p t l , cE
TL CA
EPHONE
(DAYTIME TJ) -91" �*0 .
E-MAILA 1t a1A neck.
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the i
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
0'4 71 I 11 -
(month, day, year)
Signature
(File the origin
110Y1117.0 " 1•1
r ; 'th you 11 ng official.)
ned state
ation contained
FPPC Form 700 (2016/2017)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov