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700 Bettencourt 2016 from 01/01 - 12/31CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION AMENDMENT Please type or print in ink. RECEIVED i.07l it � QU.INTAI STATEMENT OF ECONOMIC INTERESTS �%��-�" IA COVER PAGE 7017 MAR 29 PH 12: S3 NAME OF FILER Bettencourt (LAST) (FIRST) Philip (MIDDLE) Francis 1. Office, Agency, or Court Agency Name (Do not use acronyms) City of La Quinta Division, Board, Department, District, if applicable Planning Commission Your Position Chair ► If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: DNA Position: DNA 2. Jurisdiction of Office (Check at feast one box) ❑ State ❑ Multi -County ❑x City of La Quinta 0 Judge or Court Commissioner (Statewide Jurisdiction) ❑ County of ❑ Other_.. 3. Type of Statement (Check at feast one box) ❑X Annual: The period covered is January 1, 2016, through December 31, 2016. -or- 0 Leaving Office: Date Left _________1 (Check one) The period covered is through 0 The period covered is January 1, 2016, through the date of December 31, 2016. leaving office. -or- 0 The period covered is through the date of leaving office. ❑ Candidate: Election year and office sought, if different than Part 1• O Assuming Office: Date assumed 4. Schedule Summary (must complete) ► Total number of pages including this cover page' — Schedules attached X❑ Schedule A-1 • Investments — schedule attached Q Schedule A-2 - Investments — schedule attached 0 Schedule B - Real Property — schedule attached -or- None - No reportable interests on any schedule 0 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 (Business or Agency Address Recommended - Public Document) 78-498 Calle Tampico CITY La Quinta STATE Ca ZIP CODE 92253 DAYTIME TELEPHONE N(JM Eft ( 760- ) 777-7103 E-MAIL ADDRESS pnieto@La-quinta.org 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 03/28/2017 (month, day, year) Signature (File the originally signed statement with your filing official.) FPPC Form 700 (2016/2017) FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov SCHEDULE A-2 Investments, Income, and Assets of Business Entities/Trusts (Ownership Interest is 10% or Greater) R 1. BUSINESS ENTITY OR TRUST Bettencourt & Associates Name 14 Corporate Plaza, S. 120 Newport Beach 92660 Address (Business Address Acceptable) Check one 0 Trust, go to 2 (] Business Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF THIS BUSINESS Real Estate Development Planning FAIR MARKET VALUE IF APPLICABLE, LIST DATE: E $0 - $1,999 E $2,000 - $10,000 / / 16 16 __J_J ❑X $10,001 - $100,000 ACQUIRED DISPOSED E $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT • Partnership © Sole Proprietorship • Other YOUR BUSINESS POSITION Co -Principal ► 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST) • $0 - $499 1 $500 - $1,000 Il $1,001 - $10,000 • $10,001 - $100,000 © OVER $100,000 ► 3, LIST THE NAME QF EACH REPORTABLE SINGLE SOURCE OF INCOME OF $10,000 OR MORE jArticb , snp.ua,.+ sl 'Orn •,e.,..,a,y--, ❑ None or Q Names listed below NBR LLC 1 West Newport Oil Co 1 Bridgemark LLC 1 CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION AMENDMENT ► 4, INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR LEASED BY THE BUSINESS ENTITY OR TRUST Check one box: ❑ INVESTMENT ❑ REAL PROPERTY None reportable Name of Business Entity, if Investment, gC Assessor's Parcel Number or Street Address of Real Property Description of Business Activity g! City or Other Precise Location of Real Property ElMARKET VALUE U $2,000 - $10,000 ® $10,001 - $100,000 ❑ $10Q001 - $1,000,000 ❑ Over $1,000,000 IF APPLICABLE, LIST DATE: —J� 16 / / 16 ACQUIRED DISPOSED' NATURE OF INTEREST ❑ Property Ownership/Deed of Trust ❑ Stock ❑ Partnership ❑ Leasehold ❑ Other Yra. remaining ❑ Check box if additional schedules reporting investments or real property are attached Comments: M V Universal LLC 1 Bennion Deville Homes Filer's Verification Print Name Philip F. Betencourt Office, Agency or Court City of La Quints Statement Type 0 201 6/201 7 Annual ❑ Annual ❑ Assuming ❑ Leaving ❑ Candidate (yr) 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 certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date Signed 03/28/2017 Filer's Signature (month, day, year) FPPC Form 700 (2016/2017) Sch. A-2 FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov SCHEDULE B Interests in Real Property (Including Rental Income) ASSESSORS PARCEL NUMBER OR STREET ADDRESS 668-200-020 1668-200-008 1 668-200-018 CITY Unincorporated Palm Springs, Ca. FAIR MARKET VALUE IF APPLICABLE, LIST DATE: • $2,000 - $10,000 • $10,001 - $100,000 _ / / 16 / 16 X $100,001 - $1,000,000 ACQUIRED DISPOSED Over $1,000,000 NATURE OF INTEREST © Ownership/Deed of Trust • Easement J Leasehold ❑ Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED • $0 - $499 ❑ $500 - $1,000 • $1,001 - $10,000 • Leasehold In • $10,001 - $100,000 • OVER $100,000 SOURCES OF RENTAL INCOME: If you own a 10% or greater interest, list the name of each tenant that is a single source of income of $10,000 or more. © None Uninproved Properties SOURCES OF RENTAL INCOME: If you own a 10% or greater interest, list the name of each tenant that is a single source of income of $10,000 or more. © None Also 78-650 Avenida 42, No. 2216 Bermuda Dunes CALIFORNIA FORM 700 FAIRIPOLITICAL PRACTICES COMMISSION AMENDMENT I ► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS 79-040 Bermuda Dunes Dr. , Indio 92203 CITY Brermuda Dunes (Uninc. RC) FAIR MARKET VALUE IF APPLICABLE, LIST DATE: D $2,000 - $10,000 • $10,001 $100,000 /_J 16 I / 16 - , © $100,001 - $1,000,000 ACQUIRED DISPOSED • Over $1,000,000 NATURE OF INTEREST © Ownership/Deed of Trust • Easement • Leasehold In Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED • $0 - $499 • $500 - $1,000 © $1,001 - $10,000 • $10,001 - $100,000 ❑ OVER $100,000 SOURCES OF RENTAL INCOME: If you own a 10% or greater interest, list the name of each tenant that is a single source of income of $10,000 or more. © None Also 78-650 Avenida 42, No. 2216 Bermuda Dunes * You are not required to report loans from commercial lending institutions made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows: NAME OF LENDER* ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER INTEREST RATE TERM (Months/Years) OA None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 ❑ Guarantor, if applicable Filer's Verification Print Name Philip Bettencourt Office, Agency City of La Quinta or Court Statement Type ❑X 2016/2017 Annual 0 Assuming 0 Leaving ❑ Annual ❑ Candidate (yr) 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 certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. 03/28/2017 Date Signed (month, day, oar) Filer's Signature Comments: FPPC Form 700 (2016/2017) Sch. B FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov