700: Maysels - 2017 from 01/01 - 12/31Please type or print in ink.
NAME OF FILER (LAST)
MAYSELS
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
CITY OF LA QUINTA
Division, Board, Department, District, if applicable
CITY CLERK'S OFFICE
STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
(FIRST)
SUSAN
Your Position
CITY CLERK
► If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
OVERSIGHT BOARD TO THE_ LA QUINTA
Agency: SUCCESSOR AGENCY OF THE FORMER RDA Position: BOARDMEMBER
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Multi -County
n City of LA QUINTA
3. Type of Statement (Check at least one box)
® 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 / )
❑ Candidate: Date of Election
RECEIVED'
to Initial Filing Received
'JAN'3 0 208
I t,I
CITY OF LA QUINTA
CITY CLERK. DEPARTMENT
(MIDDLE)
M
❑ 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 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 C - Income, Loans, & Business Positions — schedule aftached
❑ Schedule A-2 - Investments — schedule attached ❑ Schedule D - Income — Gifts — schedule attached
❑ Schedule B - Real Property — schedule attached ❑ Schedule E - Income — Gifts — Travel Payments — schedule attached
.il
® None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business w Agency Address Recommended - Public Document)
78495 CALLE TAMPICO LA QUINTA CA 92253
DAYTIME TELEPHONE NUMBER EMAIL ADDRESS
( 760 ) 777-7123 SMAYSELS@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.
Digitally signed ay Susan y
VAryV1
ON: —Susan Maysels,o=CiCity oof f La Quinta, ou=Clerk's Office,
JANUARY 30, 2018 email=smaysels@la-quinta org, US
Date: 2018 01 30 16:35:42 -09'00'
Date Signed Signature
(month, day. year) (File the originally signed 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