700 Johnson 2018 ElectionSTATEMENT OF ECONOMIC INTERESTS
Please type or print in ink.
NAME OF FILER (LAST)
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
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Division, Board, Department, District, if applicable
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(FIRST)
COVER PAGE
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Your Position
► 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
City of —1- f4 6901k)Z
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2017, through
December 31, 2017.
.or -
4.
The period covered is ..?
December 31, 2017.
❑ Assuming Office: Date assumed
Candidate: Date of Election
RECEIVED
Date Initial Filing Received
AUG 10 20180,
CITY OF LA QUINTA
CITY CLERK DEPARTMENT
(MIDDLE)
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Left
(Check one)
through O The period covered is January 1, 2017, 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:
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-
`g 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)
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DAYTIME TELEPHONE NUMBER // % E-MAILADDRE�SS
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 /erjl under the laws of the State of California that the foregoing is tr�correctDate Signed �Signatday, year) npaf
FPPC Form 700(2017/2018)
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