700 Davidson 2017 Assuming 11/7CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
A PUBLIC DOCUMENT
Please type or print in ink.
NAME OF FILER tLASTI
V1Ci&r
1. Office, Agency, or Court
STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
RECEIVED
Date Noel 2h0.JZO17eived
,...., ,I Ls -2 Ur„
CITY OF LA QUINTA
CITY CLERK DEPARTMENT
(FIRST)
G wetr)fIhrA n
(MIDDLE)
S
Ag acy Name (Do no use acronyms)
utr14'oi.
Co rn cm 55 oner'
Division, Board,►Department, District, if a licab e
Hlb{..4 61. n. SS I 0171
I. If filing for multiple positions,I' ist below or on an attachment. (Do not use acronyms)
Your Position
Agency: _
Position.
2. Jurisdiction of Office (Check at least one box)
❑ State
i Multi -County
*City of L0" q ' v-vTcA.
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2016, through
December 31, 2016.
The period covered is through
December 31, 2016. /`�
[V
Assuming Office: Date assumed A/_//co/7
-or-
Candidate: Election year
❑ 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 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: T
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
S: Verification
❑ Schedule C - Income, Loans, & Business Positions — schedule attached
❑ Schedule D - Income — Gifts — schedule attached
['Schedule E - Income — Gifts — Travel Payments — schedule attached
MAILING ADDRESS STREET
(Business or Agency Address Recommended - Public Document)
CITY
STATE
ZIP CODE
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 fore true and correct.
Date Signed 1/ /02 O /7 Signature
(month, day, year)
(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