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700: Mendez - 2016 from 01/01 - 12/31CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION A PUBLIC DOCUMENT Please type or print in ink. STATEMENT OF ECONOMIC INTERESTS COVER PAGE RECEIVED Date IalrFitiaeryied CITY OF LA QUINTA CITY CLERK DEPARTMENT NAME OF FILER (LAST) (FIRST) Mendez Martha (MIDDLE) Beatriz 1. Office, Agency, or Court Agency Name (Do not use acronyms) City of La Quinta Division, Board, Department, District, if applicable Your Position Community Resources Public Safety Manager ► 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) ❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ Multi -County ❑ County of ❑x City of City of La Quinta ❑ Other 3. Type of Statement (Check at least one box) ▪ Annual: The period covered is January 1, 2016, through December 31, 2016. -or- The period covered is — L 1. December 31, 2016. ❑ Assuming Office: Date assumed ❑ Candidate: Election year through ❑ Leaving Office: Date Left _ _/. (Check one) O The period covered is January 1, 2016, through the date of leaving office. •or• O The period covered is _ f ! 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: 1 Schedules attached ❑ Schedule A•1 - Investments – schedule attached ❑ Schedule A-2 - Investments – schedule attached ❑x 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 (Business or Agency Address Recommended - Public Document) 78495 Calle Tampico DAYTIME TELEPHONE NUMBER ( 760 ) 777-7103 CITY La Quinta STATE CA 92253 ZIP CODE E-MAIL ADDRESS mmendez@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 03/29/2017 Signature (month, day, year) (File the . r'naly signed statement w,'ofririal.) FPPC Form 700 (2016/2017) 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 606262014 CITY Indio, CA FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $1o,001 - $100,000 ❑X $100,001 - $1,000,000 ❑ Over $1,000,000 IF APPLICABLE, LIST DATE: _/_/ 16 /. /16 ACQUIRED DISPOSED NATURE OF INTEREST ❑X Ownership/Deed of Trust ❑ Easement ❑ Leasehold ❑ Yrs remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $499 ❑ $500 - $1,000 ❑X $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. ❑X None CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION Name Martha Mendez ► ASSESSORS PARCEL NUMBER OR STREET ADDRESS 606255001 CITY Indio, CA FAIR MARKET VALUE IF APPLICABLE, LIST DATE: • $2,000 - $10,000 • $10,001 - $100,000 / / 16 / / 16 © $100,001 - $1,000,000 ACQUIRED DISPOSED • Over $1,000,000 NATURE OF INTEREST © Ownership/Deed of Trust • Easement IJ Leasehold Li 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 * 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) % ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 ❑ Guarantor, if applicable Comments: 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 ❑ $1o,001 - $100,000 ❑ Guarantor, if applicable ❑ $1,001 - $10,000 ❑ OVER $100,000 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 SCHEDULE B Interests in Real Property (Including Rental Income) O. ASSESSORS PARCEL NUMBER OR STREET ADDRESS 608150005 CITY Indio, CA FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 X❑ $100,001 - $1,000,000 ❑ Over $1,000,000 IF APPLICABLE, LIST DATE: j ./16 / /16 ACQUIRED DISPOSED NATURE OF INTEREST ❑X Ownership/Deed of Trust ❑ Easement ❑ Leasehold ❑ Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $499 ❑ $500 - $1,000 ❑X $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. ❑x None CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION Name Martha Mendez ► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS 608181026 CITY Indio, CA FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑X $100,001 - $1,000,000 ❑ Over $1,000,000 IF APPLICABLE, LIST DATE: 16 _/ / 16 ACQUIRED DISPOSED NATURE OF INTEREST ❑X Ownership/Deed of Trust ❑ Easement ❑ Leasehold ❑ Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $499 ❑ $500 - $1,000 ❑X $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. ❑X None * 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) NAME OF LENDER* ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER BUSINESS ACTIVITY, IF ANY, OF LENDER INTEREST RATE TERM (Months/Years) INTEREST RATE TERM (Months/Years) % ❑ None % ❑ None HIGHEST BALANCE DURING REPORTING PERIOD HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $10,001 - $100,000 ❑ $1,001 - $10,000 ❑ OVER $100,000 ❑ $500 - $1,000 ❑ $10,001 - $100,000 ❑ Guarantor, if applicable I I ❑ Guarantor, if applicable Comments: ❑ $1,001 - $10,000 ❑ OVER $100,000 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 SCHEDULE B Interests in Real Property (Including Rental Income) ► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS 606272022 CITY Indio, CA FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑X $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INTEREST ❑X Ownership/Deed of Trust IF APPLICABLE, LIST DATE: _j_/ 16 / / 16 ACQUIRED DISPOSED ❑ Leasehold ❑ Easement [J Yrs remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $499 ❑ $500 - $1,000 ❑X $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. ❑X None CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION Name Martha Mendez ► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS 600110018 CITY Indio, CA FAIR MARKET VALUE ❑ $2,000 - $10,000 LI 810,001 - 8100,000 ❑X 8100,001 - $1,000,000 ❑ Over $1,000,000 IF APPLICABLE. LIST DATE: 16 / /16 ACQUIRED DISPOSED NATURE OF INTEREST ❑X Ownership/Deed of Trust ❑ Easement ❑ Leasehold ❑ Yrs remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑X $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ 810,001 - 8100,000 ❑ 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. ❑Q None * 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) ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - 81,000 ❑ 81,001 - 810,000 ❑ 810,001 - 8100,000 ❑ OVER $100,000 ❑ Guarantor, if applicable Comments: NAME OF LENDER* ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER INTEREST RATE TERM (Months/Years) ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ 810,001 - 8100,000 ❑ Guarantor, if applicable ❑ $1,001 - $10,000 ❑ OVER $100,000 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 SCHEDULE C Income, Loans, & Business Positions (Other than Gifts and Travel Payments) ► 1. INCOME RECEIVED ► 1. INCOME RECEIVED NAME OF SOURCE OF INCOME Coachella Valley Housing Coalition ADDRESS (Business Address Acceptable) 45701 Monroe Street, Suite Gq CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION Name Martha Mendez NAME OF SOURCE OF INCOME ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑X $10,001 - $100,000 ❑ No Income - Business Position Only ❑ $1,001 - $10,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑X Spouse's or registered domestic partner's income (For self-employed use Schedule A-2 ) ❑ Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.) ❑ Sale of ❑ Loan repayment ❑ Commission or ❑ Rental Income, list each source of $10,000 or more (Real property, car, boat, etc.) (Describe) ❑ Other (Describe) YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑ $10,001 - $100,000 ❑ No Income - Business Position Only ❑ $1,001 - $10,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.) ❑ Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2 ) ❑ Sale of (Real property, car, boat, etc.) ❑ Loan repayment ❑ Commission or ❑ Rental Income, list each source of $10,000 or more (Describe) ❑ Other (Describe) ► 2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD * You are not required to report loans from commercial lending institutions, or any indebtedness created as part of a retail installment or credit card transaction, 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 HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - 510,000 0 510,001 - 5100,000 ❑ OVER $100,000 Comments: INTEREST RATE TERM (Months/Years) ❑ None SECURITY FOR LOAN ❑ None ❑ Personal residence ❑ Real Property Street address City ❑ Guarantor ❑ Other (Describe) FPPC Form 700 (2016/2017) Sch. C FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov