700 Bettencourt 2017 from 01/01 - 12/31Please type or print in ink.
NAME OF FILER (LAST)
Bettencourt
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of La Quinta
Division, Board, Department, District, if applicable
Planning Commission
(7"'��/' 7"'1'_7.RFPF1VED
STATEMENT OF ECONOMIC INTERESTS , �� 12028
(FIRST)
Philip
COVER PAGE
Your Position
Member
► If filing for multiple positions, list below or on an attachment, (Do not use acronyms)
Agency DNA Position: DNA
2. Jurisdiction Of Office (Check at least one box)
❑ State
❑ Multi -County
❑x City of La Quinta
I Type of Statement (Check at least one box)
CITY OF LA QUINTA
COMMUNITY DIVELOPMENT
(MIDDLE)
F.
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
❑x Annual: The period covered is January 1, 2017, through ❑ Leaving Office: Date Left I I
-or-
December 31, 2017. (Check one)
The period covered is. through O The period covered is January 1, 2017, through the date of
December 31, 2017. leaving office.
.or -
El Assuming Office: Date assumed O The period covered is I through
the date of leaving office,
❑ Candidate: Date of Election and office sought, if different than Part 1
4. Schedule Summary (must complete) ► Total number of pages including this cover page: 3
Schedules aftached
❑x Schedule A-1 - Investments — schedule attached ❑ Schedule C - Income, Loans, & Business Positions — schedule attached
❑x Schedule A-2 - Investments — schedule attached ❑ Schedule D - Income — Gifts — schedule attached
❑x Schedule B - Real Property — schedule attached ❑ Schedule E - Income — Gifts — Travel Payments — schedule attached
-or-
El None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
78-498 Calle Tampico La Quinta Calif 92253
DAYTIME TELEPHONE NUMBER E.MA]L ADDRESS
( 760 ) 777-7103 1pnieto@La-Quina.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 03-12-2018 Si nature
--i?"/3-�� .Ph w -;:A
(month, day, year) (FAtheonon*signed statement with your riling ofh'ciai.)
FPPC Form 700(2017/2018)
FPPC Advice Email: edvice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
SCHEDULE A-2 CALIFORNIA FORM
Investments, Income, and Assets FAIR POLITICAL PRACTICES COMMISSION
Name
of Business Entities/Trusts
(Ownership Interest is 10% or Greater)
► 1 BUSINESS ENTITY OR TRUST 1. BUSINESS ENTITY OR TRUST
Name
Bettencourt and Associates
Address (Business Address Acceptable)
Check one
❑ Trust, go to 2 I] Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF THIS BUSINESS
'Real Estate Development Planning
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE: 1
❑ $0 - $1,999
❑ $2,000 - $10,000
�J___J 17 _/ 117
X❑ $10,001 - $100,000
ACQUIRED DISPOSED
❑ $100,001 - $1,000,000
❑ Over $1,000,000
iNATURE OF INVESTMENT
❑ Partnership ❑X Sole Proprietorship ❑ pier
Co -Principal
YOUR BUSINESS POSITION
SHARE OF -•SS
INCOME TO THE ENTITY/TRUST)
0$0-$499
n $10,001 - $100,000
❑ $500 - $1,000
❑ OVER $100,000
$1,001 - $10,000
Name
None reportable
Address (Business Address Acceptable)
Check one
❑ Trust, go to 2 ❑ Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $0 - $1,999
❑ $2,000 - $10,000 _ __/� 1? �J 117
❑ $10,001 - $100,000 ACQUIRED DISPOSED
❑ $100,001 - $1,000,000
❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Partnership ❑ Sole Proprietorship ❑
Ulner
YOUR BUSINESS POSITION
SHARE OF ••SS INCOME TO THE ENTITY/TRUST)
0$0-$499 ❑ $10,001 - $100,000
❑ $500 - $1,000 ❑ OVER $100,000
❑ $1,001 - $10,000
e • ••• ••, •r • -•• 9.C-34 •
INCOME•OF $10,000 OR MORE INCOMEOF $10,000 OR MORE
❑ None or X❑ Names listed below ❑ None or Names fisted below
West Newport Oil Company - M V Universal LLC
LEASED BY THE BUSINESS ENTITY OR
Check one box'
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, 2[
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity gL
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000 x__/17 __j__j 17
❑ $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
❑ Property Ownership/Deed of Trust ❑ Stock ❑ Partnership
❑ Leasehold ❑ Other
Yrs. ramalrting
❑ Check box if additional schedules reporting investments or real property
are attached
Comments*
LEASED BY THE BUSINESS ENTITY OR TRUST
Check one box:
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entityif Investment, XAssessor's Parcel Number or Street Address of Real Property
Description of Business Activity gL
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000 _-__/ / 17 _J 17
❑ $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
❑ Property Ownership/Deed of Trust ❑ Stock ❑ Partnership
❑ Leasehold ❑ Other
Yrs. remaining
❑ Check box if additional schedules reporting investments or real property
are attached
FPPC Form 700 (2017/2018) Sch. A-2
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 wwwJppc.ca.gov
SCHEDULE B
Interests in Real Property Name
(Including Rental Income)
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS ► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
79-040 Bermuda Dunes Drive, Indio 92203
CITY CITY
Bermuda Dunes (Uninc Riv. co.)
FAIR MARKET VALUE
❑ $2,000 - $10,000
❑ $10,001 - $100,000
❑ $100,001 - $1,000,000
❑ Over $1,000,000
NATURE OF INTEREST
❑ Ownership/Deed of Trust
❑ Leasehold
Yrs. remaining
IF APPLICABLE, LIST DATE:
_/_/ 17 _/___/ 17
ACQUIRED DISPOSED
❑ Easement
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
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
[] Leasehold
Yrs remaining
IF APPLICABLE, LIST DATE:
/17 ��17
ACQUIRED DISPOSED
❑ Easement
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.
❑ None
Also, 78-650 Avenida 42, No. 2216 Bemuda Dunes
* 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"
DNA
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
INTEREST RATE TERM (Months/Years)
I ❑ 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'
DNA
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
FPPC Form 700(2017/2018) Sch. B
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov