700: Hallick - 2018 from 01/01 - 12/31-7
Nu I 11'CL
2018/2019
Statement of
Economic Interests
Form 700
A Public Document
Table of Contents
Quick Start Guide.....................................................p.2
Who? Where? How? When? ....................................
p.3
Types of Statements .................................................
p.4
Cover Page and Schedules
CoverPage ........................................................
p.5
Schedule A-1 (Investments) .............................-
p.7
Schedule A-2 (Business Entities/Trusts) ............
p.9
Schedule B (Real Property)...............................p.11
Schedule C (Income).........................................p.13
Schedule D (Gifts)..............................................p.15
Schedule E (Travel Payments) ...........................p.17
Restrictions and Prohibitions....................................p.19
Q&A........................................................................p.20
Helpful Resources
• Video Tutorials
• Reference Pamphlet
• Excel Version
• FAQs
• Gift and Travel Fact
Sheet for State and
Local Officials
California Fair Political Practices Commission
1102 Q Street, Suite 3000 • Sacramento, CA 95811
Email Advice: advice@fppc.ca.gov
Toll -free advice line: 1 (866) ASK-FPPC • 1 (866) 275-3772
Telephone: (916)322-5660 • Website: www.fppc.ca.gov
December 2018
CALIFORNIA•-
FAIR POLITICAL PRACTICES COMMISSION
Please type or print in ink.
NAME OF FILER (LAST)
Hallick
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of La Quinta
Division, Board, Department, District, if applicable
Finance Department
STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
A PUBLIC DOCUMENT
(FIRST)
Rosemary
Burns
Your Position
Financial Services Analyst
► 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
0 City of La Quinta
Date Ini%LF $eceived
4/
WR 7 2Q19
ClUtWbEPARTMENT
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
3. Type of Statement (Check at least one box)
0 Annual: The period covered is January 1, 2018, through ❑ Leaving Office: Date Left I I
December 31, 2018. (Check one circle.)
.or -
The period covered is I I through
December 31, 2018
❑ Assuming Office: Date assumed
❑ Candidate: Date of Election
O The period covered is January 1, 2018, through the date of
-or- leaving office.
O The period covered is l 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: 2
Schedules attached
❑x 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
❑ Schedule C - Income, Loans, B Business Positions — schedule attached
❑ Schedule D - Income — Gifts — schedule attached
❑ Schedule E - Income — Gifts — Travel Payments — schedule attached
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
78495 Calle Tampico La Quinta CA 92253
DAYTIME TELEPHONE NUMBER EMAILADDRESS
( 760 ) 777-7058 rhallick@laquintaca.gov
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 t:qper
I certify under penalty of perjury under the laws of the State of California that tcorrect.
Date Signed 3/6/2019 Signature(month, day, year) psfafementw flrgorficial.)
FPPC Form 700(2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
Page - 5
SCHEDULE A-1
Investments
Stocks, Bonds, and Other Interests
(Ownership Interest is Less Than 10%)
Investments must be itemized.
Do not attach brokerage or financial statements
► NAME OF BUSINESS ENTITY
Lowe's Companies Inc
GENERAL DESCRIPTION OF THIS BUSINESS
home improvement retail
FAIR MARKET VALUE
❑ $2,000 - $10,000 ❑ $10,001 - $100,000
❑X $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑X Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE. LIST DATE:
I— / 18 11 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
CVS Health Corp
GENERAL DESCRIPTION OF THIS BUSINESS
retail pharmacy/healthcare
FAIR MARKET VALUE
❑ $2,000 - $10,000 ❑X $10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑X Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
11 ) 28) 18 I 118
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
Starbucks
GENERAL DESCRIPTION OF THIS BUSINESS
retail/restaurant
FAIR MARKET VALUE
❑ $2,000 - $10,000 X❑ $10.001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑X Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE
08)16),$ 18
ACQUIRED DISPOSED
Comments:
CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
► NAME OF BUSINESS ENTITY
Chevron Corp
GENERAL DESCRIPTION OF THIS BUSINESS
energy industry
FAIR MARKET VALUE
❑X $2,000 - $10,000 ❑ $10,001 - $100.000
❑ $100,001 - $1,000-000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑X Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
03)05(18 1 118
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
Royal Dutch Shell
GENERAL DESCRIPTION OF THIS BUSINESS
energy industry
rLIMMlITirdC13 Ar9_111111U e
7 $2.000 - $10,000 ❑X $10,001 - $100,000
❑ $100-001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑X Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
I / 18 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
❑ $2,000 - $10,000 ❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE. LIST DATE:
) ) 18 ( ( 18
ACQUIRED DISPOSED
FPPC Form 700(2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
Page - 7