700: Maysels - 2018 Leaving Office 07/11/18V/
STATEMENT OF ECONOMIC INTERESTS
DOCUMENTA PUBLIC COVER PAGE
Please type or print in ink.
NAME OF FILER (LAST) (FIRST)
Maysels Susan M
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of La Quinta
Division, Board, Department, District, if applicable Your Position
City Clerk's Office City Clerk
P. If filing for multiple positions, list below or on an attachment. (Do not use acronyms) }
Agency 04G r 5 rl k+ 8 C)&rd Position: r�t�
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, 2016, through
December 31, 2016.
.or -
The period covered is
December 31, 2016.
❑ Assuming Office: Date assumed
❑ Candidate: Election year
Da s Initial Fill"ng3FNRied
Ofbcia' Use Only
JUN 2 0 2018
CITY OF LA QUINTA
MENT
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
LIQ Leaving Office: Date Left
(Check one) —
through O The period covered is January 1, 2016, through the date of
leaving office.
.or- p
O The period covered is i 1 �l R , through
the date of leaving office,
and office sought, if different than Part 1:
4. Schedule Summary (must complete) I► 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 -
W None - No reportable interests on any schedule
5. Verification
❑ Schedule C - Income, Loans, & Business Positions — schedule attached
❑ Schedule D - Income — Gilts — schedule attached
❑ Schedule E - Income — Gifts — Travel Payments — schedule attached
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
DAYTIME TELEPHONE NUMBER �' E-MAIL ADDRESS
( T4s) 1+q 901Hlro� - fit.
I have used all reasonable diligence in preparing this statement. I have reviewed this state nt and to the best of my awk l dg the informs i n 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 4U. �0{ ;?41 g Signature � � • .
(monlh, day, year) (File the onginally signed statement with ri<ing official.)
FPPC Form 700(2016/2017)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov