700 Radi 2018 from 01/01 to 12/31STATEMENT OF ECONOMIC INTERESTS Date Initial Filing Received
• ' • ' 700
Official Use Only
POLITICALFAIR COVER PAGE
Filed Date: 03/04/2019 02:55 PM
Please type or print in ink. A PUBLIC DOCUMENT SAN: FPPC
NAME OF FILER (LAST) (FIRST) (MIDDLE)
Radi Robert
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of La Quinta
Division, Board, Department, District, if applicable Your Position
City Council Member
► 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 ❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ Multi -County ❑ County of
x❑ City of La Quinta ❑ Other
3. Type of Statement (Check at least one box)
0 Annual: The period covered is January 1, 2018, through ❑ Leaving Office: Date Left
-or-
December 31, 2018. (Check one circle.)
The period covered is through O The period covered is January 1, 2018, through the date of
December 31, 2018. -or- leaving office.
❑ Assuming Office: Date assumed O The period covered is/ through
the date of leaving office.
❑ Candidate: Date of Election and office sought, if different than Part 1:
4. Schedule Summary (must complete) ► Total number of pages including this cover page: 15
Schedules attached
❑x Schedule A-1 - Investments — schedule attached
❑R Schedule A-2 - Investments — schedule attached
❑R Schedule B - Real Property — schedule attached
-or- ❑ None - No reportable interests on any schedule
5. Verification
❑x Schedule C - Income, Loans, & Business Positions — schedule attached
❑x 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)
79405 Highway 111 Ste 9-318 La Quinta CA 92253-8300
DAYTIME TELEPHONE NUMBER EMAIL ADDRESS
(
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
03/04/2019 02:55 PM
(month, day, year)
Signature
Electronic Submission
(File the originally signed paper statement with your filing official.)
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
Aurora Cannabis Inc
GENERAL DESCRIPTION OF THIS BUSINESS
Canadian licensed cannabis producer
FAIR MARKET VALUE
❑X $2,000 - $10,000 ❑ $10,001 - $100,000
$100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
Q Stock ❑ Other
(Describe)
❑ Partnership Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
/ / 18 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
Charlotte's Web Holding Inc
GENERAL DESCRIPTION OF THIS BUSINESS
Wellness products
FAIR MARKET VALUE
❑X $2,000 - $10,000 ❑ $10,001 - $100,000
$100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
Q Stock ❑ Other
(Describe)
❑ Partnership Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
/ /18 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
ALIBABA GROUP HLDG LTD ADR
GENERAL DESCRIPTION OF THIS BUSINESS
Ecommerce
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on schedule C)
IF APPLICABLE, LIST DATE:
/ /18 18
ACQUIRED DISPOSED
Comments:
Name
Robert Radi
► NAME OF BUSINESS ENTITY
Canopy Growth Corp
GENERAL DESCRIPTION OF THIS BUSINESS
Cannabis company
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ii 18 ii 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
BAIDU INC
GENERAL DESCRIPTION OF THIS BUSINESS
Ecommerce
FAIR MARKET VALUE
❑ $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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ii 18 ii 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
Ishares trust Core
GENERAL DESCRIPTION OF THIS BUSINESS
Exchange -traded funds
FAIR MARKET VALUE
�X $2,000 - $10,000 $10,001 - $100,000
El $100,001 - $1,000,000 Over $1,000,000
NATURE OF INVESTMENT
❑X Stock Other
(Describe)
Partnership Q Income Received of $0 - $499
Q 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
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
CISCO SYSTEM INC
GENERAL DESCRIPTION OF THIS BUSINESS
IT and Networking Company
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
/ / 18 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
Constellation Brands Inc
GENERAL DESCRIPTION OF THIS BUSINESS
Beer import company
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
/ /18 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
Dollar General Corp
GENERAL DESCRIPTION OF THIS BUSINESS
American chain of variety stores
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on schedule C)
IF APPLICABLE, LIST DATE:
/ /18 18
ACQUIRED DISPOSED
Comments:
Name
Robert Radi
► NAME OF BUSINESS ENTITY
Covered By SIPC
GENERAL DESCRIPTION OF THIS BUSINESS
Securities Investor Protection Corporation
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ii 18 ii 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
ENBRIDGE INC
GENERAL DESCRIPTION OF THIS BUSINESS
Crude oil and liquids transportation
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ii 18 ii 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
EXPEDIA INC
GENERAL DESCRIPTION OF THIS BUSINESS
Online Travel Booking
FAIR MARKET VALUE
�X $2,000 - $10,000 $10,001 - $100,000
El $100,001 - $1,000,000 Over $1,000,000
NATURE OF INVESTMENT
❑X Stock Other
(Describe)
Partnership Q Income Received of $0 - $499
Q 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
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
Verizon Communications
GENERAL DESCRIPTION OF THIS BUSINESS
Communications
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
/ / 18 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
Fedex Corp
GENERAL DESCRIPTION OF THIS BUSINESS
Courier delivery services
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
/ /18 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
Galmed Pharmaceuticals LTD
GENERAL DESCRIPTION OF THIS BUSINESS
Biopharmaceutical company
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on schedule C)
IF APPLICABLE, LIST DATE:
/ /18 18
ACQUIRED DISPOSED
Comments:
Name
Robert Radi
► NAME OF BUSINESS ENTITY
ISHARES CORE
GENERAL DESCRIPTION OF THIS BUSINESS
Broad stock and bond index funds
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ii 18 ii 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
JD COM INC
GENERAL DESCRIPTION OF THIS BUSINESS
Ecommerce
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ii 18 ii 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
Global X FDS
GENERAL DESCRIPTION OF THIS BUSINESS
Exchange -traded funds
FAIR MARKET VALUE
�X $2,000 - $10,000 $10,001 - $100,000
El $100,001 - $1,000,000 Over $1,000,000
NATURE OF INVESTMENT
❑X Stock Other
(Describe)
Partnership Q Income Received of $0 - $499
Q 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
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
KINDER MORGAN INC
GENERAL DESCRIPTION OF THIS BUSINESS
Energy infrastructure
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
/ / 18 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
Ishares Trust
GENERAL DESCRIPTION OF THIS BUSINESS
Exchange -traded funds
FAIR MARKET VALUE
❑X $2,000 - $10,000 ❑ $10,001 - $100,000
$100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
Q Stock ❑ Other
(Describe)
❑ Partnership Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
/ /18 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
Lexinfintech Holdings LTD
GENERAL DESCRIPTION OF THIS BUSINESS
Online consumer finance platform
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on schedule C)
IF APPLICABLE, LIST DATE:
/ /18 18
ACQUIRED DISPOSED
Comments:
Name
Robert Radi
► NAME OF BUSINESS ENTITY
IPG Photonics Corp
GENERAL DESCRIPTION OF THIS BUSINESS
Fiber lasers
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ii 18 ii 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
Kansas City Southern
GENERAL DESCRIPTION OF THIS BUSINESS
Railway network
FAIR MARKET VALUE
❑ $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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ii 18 ii 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
OPKO Health Inc
GENERAL DESCRIPTION OF THIS BUSINESS
Healthcare
FAIR MARKET VALUE
�X $2,000 - $10,000 $10,001 - $100,000
El $100,001 - $1,000,000 Over $1,000,000
NATURE OF INVESTMENT
❑X Stock Other
(Describe)
Partnership Q Income Received of $0 - $499
Q 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
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
Raytheon Co
GENERAL DESCRIPTION OF THIS BUSINESS
U.S. defense contractor
FAIR MARKET VALUE
❑X $2,000 - $10,000 ❑ $10,001 - $100,000
$100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
Q Stock ❑ Other
(Describe)
❑ Partnership Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
/ / 18 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
SPDR SERIES TRUST AEROSPACE DEF
GENERAL DESCRIPTION OF THIS BUSINESS
Aerospace
FAIR MARKET VALUE
❑ $2,000 - $10,000 �X $10,001 - $100,000
❑ $100,001 - $1,000,000 F1 Over $1,000,000
NATURE OF INVESTMENT
�X Stock ❑ Other
(Describe)
❑ Partnership Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
/ /18 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
Shopify Inc
GENERAL DESCRIPTION OF THIS BUSINESS
Ecommerce software
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on schedule C)
IF APPLICABLE, LIST DATE:
/ /18 18
ACQUIRED DISPOSED
Comments:
Name
Robert Radi
► NAME OF BUSINESS ENTITY
VANGUARD FTSE
GENERAL DESCRIPTION OF THIS BUSINESS
Financial
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ii 18 ii 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
Realty Income Corp
GENERAL DESCRIPTION OF THIS BUSINESS
Real estate investment trust
FAIR MARKET VALUE
❑ $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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ii 18 ii 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
VISA INC
GENERAL DESCRIPTION OF THIS BUSINESS
Payment technology
FAIR MARKET VALUE
❑ $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 Q Income Received of $0 - $499
Q 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
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
Simon Property Group Inc
GENERAL DESCRIPTION OF THIS BUSINESS
Commercial real estate
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
/ / 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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
/ /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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on schedule C)
IF APPLICABLE, LIST DATE:
/ /18 18
ACQUIRED DISPOSED
Comments:
Name
Robert Radi
► NAME OF BUSINESS ENTITY
Tilray Inc
GENERAL DESCRIPTION OF THIS BUSINESS
Canadian pharmaceutical
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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ii 18 ii 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 Q Income Received of $0 - $499
Q Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ii 18 ii 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 Q Income Received of $0 - $499
Q 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
SCHEDULE A-2 CALIFORNIA FORM700
Investments, Income, and Assets FAIR POLITICAL PRACTICES COMMISSION
of Business Entities/Trusts Name
(Ownership Interest is 10% or Greater) Robert Radi
Intergral Advantage
Name
79405 Hwy 111 Ste 9-315 La Quinta CA 92253
Address (Business Address Acceptable)
Check one
❑ Trust, go to 2 ❑x Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF THIS BUSINESS
Strategic Advisory
FAIR MARKET VALUE
❑ $0 - $1,999
❑ $2,000 - $10,000
❑X $10,001 - $100,000
❑ $100,001 - $1,000,000
❑ Over $1,000,000
I YOUR BUSINESS POSITION
IF APPLICABLE, LIST DATE:
18 18
ACQUIRED DISPOSED
❑ $0 - $499 ❑ $10,001 - $100,000
❑ $500 - $1,000 ❑ OVER $100,000
Q $1,001 - $10,000
None or I i Names listed below
ll� 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD O-
LEASED BY THE BUSINESS ENTITY •
Check one box:
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, or
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity or
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000 18 18
❑ $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
❑ Property Ownership/Deed of Trust ❑ Stock ❑ Partnership
❑ Leasehold ❑ Other
Yrs. remaining
❑ Check box if additional schedules reporting investments or real property
are attached
Name
Address (Business Address Acceptable)
Check one
❑ Trust, go to 2 ❑ Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $0 - $1,999
❑ $2,000 - $10,000 / 18 / 18
❑ $10,001 - $100,000 ACQUIRED DISPOSED
❑ $100,001 - $1,000,000
❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Partnership ❑ Sole Proprietorship ❑
Other
YOUR BUSINESS POSITION
❑ $0 - $499 ❑ $10,001 - $100,000
❑ $500 - $1,000 ❑ OVER $100,000
❑ $1,001 - $10,000
None or i I Names listed below
4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR
LEASED BY THE BUSINESS ENTITY OTRUST
-
Check one box:
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, or
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity or
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000 �� 18 �� 18
❑ $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
❑ Property Ownership/Deed of Trust ❑ Stock ❑ Partnership
❑ Leasehold ❑ Other
Yrs. remaining
❑ Check box if additional schedules reporting investments or real property
are attached
Comments:
FPPC Form 700(2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
Page - 9
SCHEDULE B
Interests in Real Property
(Including Rental Income)
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
773325005-8
CITY
La Quinta
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000 / 18 �� 18
❑X $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
❑X Ownership/Deed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remaining Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000
X❑ $10,001 - $100,000 ❑ OVER $100,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater
interest, list the name of each tenant that is a single source of
income of $10,000 or more.
❑ None
Lee Silver (9/1/17 - 8/1/18)
Michael and Michelle BroOKer - current)
Name
Robert Radi
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
774065007-4
CITY
La Quinta
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000 / / 18 �� 18
❑X $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
❑X Ownership/Deed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remaining Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000
❑X $10,001 - $100,000 ❑ OVER $100,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater
interest, list the name of each tenant that is a single source of
income of $10,000 or more.
❑ None
Tamara Fisher (current)
* You are not required to report loans from a commercial lending institution made in the lender's regular course of
business on terms available to members of the public without regard to your official status. Personal loans and
loans received not in a lender's regular course of business must be disclosed as follows:
NAME OF LENDER"
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY. IF ANY. OF LENDER
INTEREST RATE TERM (Months/Years)
% ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
❑ Guarantor, if applicable
Comments:
NAME OF LENDER"
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
INTEREST RATE TERM (Months/Years)
% ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
❑ Guarantor, if applicable
FPPC Form 700(2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
Page - 11
SCHEDULE B
Interests in Real Property
(Including Rental Income)
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
774213032-3
CITY
La Quinta
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000 / 18 �� 18
❑x $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
❑X Ownership/Deed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remaining Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater
interest, list the name of each tenant that is a single source of
income of $10,000 or more.
❑X None
Name
Robert Radi
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
774252016-0
CITY
La Quinta
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000 / / 18 �� 18
❑x $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
❑X Ownership/Deed of Trust ❑ Easement
❑ Leasehold ❑
Yrs. remaining Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000
0 $10,001 - $100,000 ❑ OVER $100,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater
interest, list the name of each tenant that is a single source of
income of $10,000 or more.
❑ None
Heather and Don Merryman (3/1/15 - current)
* You are not required to report loans from a commercial lending institution made in the lender's regular course of
business on terms available to members of the public without regard to your official status. Personal loans and
loans received not in a lender's regular course of business must be disclosed as follows:
NAME OF LENDER"
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY. IF ANY. OF LENDER
INTEREST RATE TERM (Months/Years)
% ❑ None
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
❑ Guarantor, if applicable
Comments:
NAME OF LENDER"
Amerihome Mortgage
ADDRESS (Business Address Acceptable)
1 Baxter Way, Suite 300 Thousand Oaks, CA 91362-3888
BUSINESS ACTIVITY, IF ANY, OF LENDER
INTEREST RATE
3.75
❑ None
TERM (Months/Years)
9/2032
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑X OVER $100,000
❑ Guarantor, if applicable
FPPC Form 700(2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
Page - 11
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOME
Benedictine University
ADDRESS (Business Address Acceptable)
5700 College Rd Lisle, IL
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
Adjunct Professor
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $500 - $1,000 ❑ $1,001 - $10,000
0 $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
XI Salary ❑ Spouse's or registered domestic partner's income
(For self-employed use Schedule A-2.)
❑ Partnership (Less than 10% ownership. For 10% or greater use
Schedule A-2.)
❑ Sale of
❑ Loan repayment
❑ Commission or
❑ Other
(Real property, car, boat, etc.)
❑ Rental Income, list each source of $10,000 or more
(Describe)
(Describe)
Name
Robert Radi
NAME OF SOURCE OF INCOME
California State University San Bernardino
ADDRESS (Business Address Acceptable)
5500 University Pkwy, San Bernardino, CA 92407
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
Adjunct Professor
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $500 - $1,000 Q $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
❑X Salary ❑ Spouse's or registered domestic partner's income
(For self-employed use Schedule A-2.)
❑ Partnership (Less than 10% ownership. For 10% or greater use
Schedule A-2.)
❑ Sale of
❑ Loan repayment
❑ Commission or
❑ Other
(Real property, car, boat, etc.)
❑ Rental Income, list each source of $10,000 or more
(Describe)
(Describe)
* You are not required to report loans from a commercial lending institution, or any indebtedness created as part of
a retail installment or credit card transaction, made in the lender's regular course of business on terms available to
members of the public without regard to your official status. Personal loans and loans received not in a lender's
regular course of business must be disclosed as follows:
NAME OF LENDER*
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY. IF ANY. OF LENDER
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000
❑ $1,001 - $10,000
❑ $10,001 - $100,000
❑ OVER $100,000
Comments:
INTEREST RATE TERM (Months/Years)
% ❑ None
SECURITY FOR LOAN
❑ None ❑ Personal residence
❑ Real Property
❑ Guarantor
❑ Other
Street address
city
(Describe)
FPPC Form 700(2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
Page -13
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOME
City of La Quinta
ADDRESS (Business Address Acceptable)
78495 Calle Tampico La Quinta, CA 92253
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
City councilman
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $500 - $1,000 ❑ $1,001 - $10,000
0 $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
XI Salary ❑ Spouse's or registered domestic partner's income
(For self-employed use Schedule A-2.)
❑ Partnership (Less than 10% ownership. For 10% or greater use
Schedule A-2.)
❑ Sale of
(Real property, car, boat, etc.)
❑ Loan repayment
❑ Commission or ❑ Rental Income, list each source of S10,000 or more
❑ Other
(Describe)
(Describe)
Name
Robert Radi
NAME OF SOURCE OF INCOME
Coachella Valley Unified School District
ADDRESS (Business Address Acceptable)
87225 Church St Thermal CA 92274
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
Teacher
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $500 - $1,000 ❑ $1,001 - $10,000
Q $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
❑ Salary ❑X Spouse's or registered domestic partner's income
(For self-employed use Schedule A-2.)
❑ Partnership (Less than 10% ownership. For 10% or greater use
Schedule A-2.)
❑ Sale of
(Real property, car, boat, etc.)
❑ Loan repayment
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
❑ Other
(Describe)
(Describe)
* You are not required to report loans from a commercial lending institution, or any indebtedness created as part of
a retail installment or credit card transaction, made in the lender's regular course of business on terms available to
members of the public without regard to your official status. Personal loans and loans received not in a lender's
regular course of business must be disclosed as follows:
NAME OF LENDER* INTEREST RATE TERM (Months/Years)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY. IF ANY. OF LENDER
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000
❑ $1,001 - $10,000
❑ $10,001 - $100,000
❑ OVER $100,000
Comments:
% ❑ None
SECURITY FOR LOAN
❑ None ❑ Personal residence
❑ Real Property
Street address
❑ Guarantor
❑ Other
city
(Describe)
FPPC Form 700(2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
Page -13
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOME
Pepperdine University
ADDRESS (Business Address Acceptable)
6100 Center Dr, Los Angeles, CA 90045
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
Adjunct Professor
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $500 - $1,000 ❑ $1,001 - $10,000
0 $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
XI Salary ❑ Spouse's or registered domestic partner's income
(For self-employed use Schedule A-2.)
❑ Partnership (Less than 10% ownership. For 10% or greater use
Schedule A-2.)
❑ Sale of
❑ Loan repayment
❑ Commission or
❑ Other
(Real property, car, boat, etc.)
❑ Rental Income, list each source of $10,000 or more
(Describe)
(Describe)
Name
Robert Radi
NAME OF SOURCE OF INCOME
SunLine Transit Agency
ADDRESS (Business Address Acceptable)
32505 Harry Oliver Trail, Thousand Palms, CA 92276
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
Vice Chair
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
Q $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
❑ Salary ❑ Spouse's or registered domestic partner's income
(For self-employed use Schedule A-2.)
❑ Partnership (Less than 10% ownership. For 10% or greater use
Schedule A-2.)
❑ Sale of
❑ Loan repayment
❑ Commission or
❑x Other Stipend
(Real property, car, boat, etc.)
❑ Rental Income, list each source of $10,000 or more
(Describe)
(Describe)
* You are not required to report loans from a commercial lending institution, or any indebtedness created as part of
a retail installment or credit card transaction, made in the lender's regular course of business on terms available to
members of the public without regard to your official status. Personal loans and loans received not in a lender's
regular course of business must be disclosed as follows:
NAME OF LENDER*
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY. IF ANY. OF LENDER
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000
❑ $1,001 - $10,000
❑ $10,001 - $100,000
❑ OVER $100,000
Comments:
INTEREST RATE TERM (Months/Years)
% ❑ None
SECURITY FOR LOAN
❑ None ❑ Personal residence
❑ Real Property
❑ Guarantor
❑ Other
Street address
city
(Describe)
FPPC Form 700(2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
Page -13
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOME
The Chicago School of Professional Psychology
ADDRESS (Business Address Acceptable)
325 N Wells St, Chicago, IL 60654
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
Affiliate Professor & Research Faculty
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $500 - $1,000 ❑ $1,001 - $10,000
0 $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
X❑ Salary ❑ Spouse's or registered domestic partner's income
(For self-employed use Schedule A-2.)
❑ Partnership (Less than 10% ownership. For 10% or greater use
Schedule A-2.)
❑ Sale of
❑ Loan repayment
❑ Commission or
❑ Other
(Real property, car, boat, etc.)
❑ Rental Income, list each source of $10,000 or more
(Describe)
(Describe)
Name
Robert Radi
NAME OF SOURCE OF INCOME
University of Maryland
ADDRESS (Business Address Acceptable)
College Park, MD 20742
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
Adjunct Associate Professor
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $500 - $1,000 ❑ $1,001 - $10,000
Q $10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
❑X Salary ❑ Spouse's or registered domestic partner's income
(For self-employed use Schedule A-2.)
❑ Partnership (Less than 10% ownership. For 10% or greater use
Schedule A-2.)
❑ Sale of
❑ Loan repayment
❑ Commission or
❑ Other
(Real property, car, boat, etc.)
❑ Rental Income, list each source of $10,000 or more
(Describe)
(Describe)
* You are not required to report loans from a commercial lending institution, or any indebtedness created as part of
a retail installment or credit card transaction, made in the lender's regular course of business on terms available to
members of the public without regard to your official status. Personal loans and loans received not in a lender's
regular course of business must be disclosed as follows:
NAME OF LENDER*
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY. IF ANY. OF LENDER
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000
❑ $1,001 - $10,000
❑ $10,001 - $100,000
❑ OVER $100,000
Comments:
INTEREST RATE TERM (Months/Years)
% ❑ None
SECURITY FOR LOAN
❑ None ❑ Personal residence
❑ Real Property
❑ Guarantor
❑ Other
Street address
city
(Describe)
FPPC Form 700(2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
Page -13
SCHEDULE D
Income — Gifts
► NAME OF SOURCE (Not an Acronym)
Rutan & Tucker, LLP
ADDRESS (Business Address Acceptable)
611 Anton Boulevard, 14th Floor Costa Mesa, CA 92626
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
city dinner meeting during the
10 / 12 / 18 $ 276.94 Annual League Conference
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
$
$
$
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
Comments:
Name
Robert Radi
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
/ $
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S)
FPPC Form 700(2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
Page -15