700: Larson - 2017 from 01/01 - 12/31Please type or print in ink.
NAME OF FILER (USTI
Lct►rso"
STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
(FIRST)
L/ 5�-i +�►
1. Office, Agency, or Court L rr V V 0-- L c, &,k kk4eA_
RECEIVED
MA)r 7) 2W
CITY OF LA CIUINTA
CITY CLERIC DEPARTMENT
Agency Name (Dn not use acronyms)
colMhito"4t/ (Zesourcic,S F3v5iV`-e5S k/1Division, Bodrd, Department, District, if applicable ' Your Position
► 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 -County".
City of .-f�i (t'r-fvn
3. Type of Statement (Check at feast one box)
Annual: The period covered is January 1, 2017, through
December 31, 2017.
-or-
The period covered is
December 31, 2017.
❑ Assuming Office: Date assumed
❑ Candidate: Date of Election
(MIDDLE)
❑ 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
-or-
leaving office.
O The period covered is I 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 -
X_ 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
(BusirresS or Agency Address Recommended - Public Document)
_Utk'l5� GALLS IAMPIGo LA-&.Ulrr`A CA R�y53
DAYTIME TELEPHONE NUMBER E-MAIL ADDRESS
(7tro) 777 7bt5 I -t(ItrsokA-(j.tAl41-C, .0ir
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best a my knowledge the irArmation 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 `1/712 a `i Signature I_
(month, day, year) (File V1h. agp lya sfatemerd with your fifing official)
FPPC Form 700(2017/2018)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov