700 Llort 2016 ElectionSTATEMENT OF ECONOMIC INTERESTS RECEIVE011 � t
DOCUMENTA PUBLIC COVER PAGE AUG 1 1 2016
Please type or print in ink.
NAME OF FILER (LAST) (FIRST)
Llort Victoria CITY CLERK DEPARTMENT ;
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
Gily--GoundlrneFnber- City of La Quinta
Division, Board, Department, District, if applicable Your Position
-La-Qui►nta-- N/A VO- Candidate
P. If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
N/A AA,
Agency; Position: jV
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Multi -County
0 City of La Quinta
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 i I
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Left J�
(Check one)
through O The period covered is January 1, 2015, through the date of
leaving office.
.or-
0 The period covered is I / through
the date of leaving office.
0 Candidate: Election year 2016 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 attach ❑ Schedule C - Income, Loans, & Business Positions — schedule attached
❑ Schedule A-2 - Investments — schedule attached ❑ Schedule D - income — Gifts — schedule attached
❑ Schedule 8 - Real Property — schedule attached ❑ Schedule E - Income — Gifts — Travel Payments — Schedule attached
.or-
7 None - No reportable interests on any sci►edule
5. Verification
MAILING ADDRESS STREET CH r STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
La Quinta CA 92253
DAYTIME TELEPHONE NUMBER E-MAIL ADDRESS
( f
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 August 11, 2016 Signature`
(month, day, year) r,fe the onginally signed 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