700: Maysels - 2017 from 01/01 - 12/31 (2)Please type or print in ink.
NAME OF FILER (LAST)
MAYSELS
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
CITY OF LA QUINTA
Division, Board, Department, District, if applicable
CITY CLERK'S OFFICE
STATEMENT OF ECONOMIC INTEREST,
COVER PAGE `
(FIRST)
SUSAN
HIP
CliAN OF L` QUINTA
WX CLERK DCPART"4T
(MIDDLE)
a
Your Position
CITY CLERK
P. If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
OVERSIGHT BOARD TO THE LA QUINTA
Agency: SUCCESSOR AGENCY OF THE FORMER RDA Position: BOARDMEMBER
2. Jurisdiction of Office (Check at feast one box)
❑ State
❑ Multi -County
O City of LA QUINTA
3. Type of Statement (Check at least one box)
® Annual: The period covered is January 1, 2017, through
December 31, 2017.
-or-
The period covered is I
December 31, 2017,
❑ Assuming Office: Date assumed
❑ Candidate: Date of Election
❑ Judge or Court Commissioner (Statewide Jurisdiction)
n County of
❑ Other
❑ Leaving Office: Date Left �J
(Check one)
through O The period covered is January 1, 2017, through the date of
leaving office.
.or-
0 The period covered is I I 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
o. verincatlon
MAILING ADDRESS STREET
(Business or Agency Address Recommended - Public Document)
78495 CALLE TAMPICO
DAYTIME TELEPHONE NUMBER
(760 ) 777-7123
❑ Schedule C - Income, Loans, & Business Positions — schedule attached
❑ Schedule D - Income — Gifts — schedule attached
❑ Schedule E - Income — Gifts — Travel Payments — schedule attached
CITY STATE ZIP CODE
LA QUINTA CA 92253
E-MAIL ADURtSS
SMAYSELS@LA-QU INTA.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.
r' Digitally signed by Susan Maysels
DN: cn=Susan Maysels, o=Clry of La Quin[a, ou=Clerk's Office.
JANUARY 30 2018 email=smayseis@la-quima.urg, USDate Signed ' Signature Dane: 2018.01,3019;35A2 OWOU
(month, day, year) (File the originally signed statement with your filing official.)
FPPC Form 700(2017/2018)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov