700 Johnson 2016 ElectionSTATEMENT OF ECONOMIC INTEREST')
COVER PAGE
Please type or print in ink.
NAME OF FILER (LAST) (FIRST)
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
C / T Y vlr 1 It C�itJfN 7'� L7 if Ty
Division, Board, Department, District, if applicable Your Position �l VA
► 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
5.City of
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2015, through
December 31, 2015.
.or -
The period covered is
December 31, 2015.
❑ Assuming Office: Date assumed
RECENED
Date Initial Filing Received
Official use ONy
AUG 12 2016
CITY OF LA QUINTA
rr'ry rt FPI< rZFPARTMENT
1111fUULCt
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Left --J---J
(Check one)
through O The period covered is January 1, 2015, through the date of
-or-
leaving office.
O The period covered is through
the date of leaving office.
r Candidate: Election year Zv16 and office sought, if different than Part 1:
4. Schedule Summary (must complete) P. 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
(Business or Agency Address Recommended - Public Document)
LA 4V1du-7':r 0 A- 2 Z�"3
DAYTIME TELEPHONE NUMBER � EMAIL ADDRESS
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 "theegoing is tru and correct.
Date Signed1�i
�� Sigrl��� `
rh, day, year) rR a ongrna+ryos�gned statement with your riling official)
FPPC Form 700(2015/2016)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov