700: Triplett - 2017 from 01/01 - 12/31RECEIVED
CALIFORNIA FORm700 STATEMENT OF ECONOMIC INTERES S IAN 2013
FAIR POLITICAL PRACTICES COMMISSION
A PUBLIC DOCUMENT COVER PAGE CITY OF LA OUINTA
Please type or print in ink. CITY CLERK DEPARTMENT
NAMEE OR (LA iN(F7RSTt
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1. Office, gency, or Courtkel-
c."O Name use ac t, l ya &)
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n, Ta�ard�pa�rrlent, District, if applicable
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(MIDDLE)
your Position
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► 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
❑ Multi -Count
.City of LV1Yx%-�.
3. Type of Statement (Check at least one box)
J1 Annual: The period covered is January 1, 2017, through
December 31, 2017.
-or-
The period covered is __J__J
December 31, 2017.
❑ Assuming Office: Date assumed 1. !
❑ Candidate: Date of Election
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Left ;
(Check one)
through O The period Covered is January 1, 2017, through the date of
leaving office.
.or -
0 The period covered is ----J----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
5. 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 CITY STATE ZIP CODE
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DAYTIME T5LEPHONE NUMBER� E-MAILA S p OD )A .
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the infol Ijon 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 ' e and rrect.
Date Signed �r �� ?t Signature
(month, day, year) gir ly s ad statement with your filing official.)
FPPC Form 700(2017/2018)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov