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700 Fitzpatrick 2016 ElectionSTATEMENT OF ECONOMIC INTERESTS RECEIVFU COVER PAGE Please type or print in ink. NAME OF FILER (LAST) (FIRST) - rrr eir ela�la� 1. Office, Agency, or Court Agency Name (Do not use acronyms) �7�6F 1A tT Il�XI� Division, Board, Department, District, if applicable Your Position /?� �. )OA X4 L, '1C (A1( ► If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ Multi -County City of Z—A �'uir �/ F-1- 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 Candidate: Election year C fJ1_11 Position: CITY C F LA OUINTA CrTY CLERK DEPARTMENT ONArd CI .L (MIOf]LEj ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ County of ❑ Other ❑ Leaving Office: Date Left i (Check one) through O The period covered is January 1, 2015, through the date of leaving office. .or- 0 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 A-2 - Investments — schedule attached ❑ Schedule B - Real Property — schedule attached .or - 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 Remminended - Public ❑ocumenf) 41 DAYTIME RLEPHONE NUMBE E-MAIL ADDRESS I have used all reasonable diligence In p>eparing this statement. I have reviewed this statement and to th�bes! of my kn�dge'lhe 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 fore oing is trile7and correct. �j �j� �ffi'clial) DateSigned 'T � U ,6J,1SiImonth, day, year) (File the originally sign FPPC Form 700 (2015/2016) FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov