700 Triplett 2019 from 01/01 to 12/31STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
Please type or print in ink. A PUBLIC DOCUMENT
RECEIVED
IJAR 0 6 2020
CITY OF LA QUINTA
CITY CLERK 17FPAPTMr-
NAME OF FILER (LAST) (FIRST) iMIDDLEI
Triplett Alcadia Mae
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of La Quinta
Division, Board, Department, District, if applicable
Human Resources Division
Your Position
Human Resources Analyst
► If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Multi -County
x❑ City of La Quinta
Position:
❑ Judge, Retired Judge, Pro Tern Judge, or Court Commissioner
(Statewide Jurisdiction)
n (.niinty of
❑ Other
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2019, through ❑ Leaving Office: Date Left li I
December 31, 2019. (Check one circle.)
-or-
The period covered is J I through O The period covered is January 1, 2019, through the date of
December 31, 2019. -or-leaving office.
❑ Assuming Office: Date assumed 1 O The period covered is �� , through
❑ Candidate: Date of Election
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- x❑ None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET GITY
(Business or Agency Address Recommended - Public Document)
—)R"5 rn a 0b 7ahi-o) " �A AU
❑ Schedule C - Income, Loans, & Business Positions — schedule attached
❑ Schedule D - Income — Gifts — schedule attached
❑ Schedule E - Income — Gifts — Travel Payments — schedule attached
STATE ZIP CODE
� I�3
DAYTIME TELEPHONE NtIVISER f 4 EMAILADDRESS
1 have used all reasonable diligence in preparing this statement. I have reviewed this sta went and to lhqeVt4my
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 o5 Lo 10 b-0 t! Signature
(month, day, year) (File the od9ina17y si ned paper sl
information contained
your filing official.)
FPPC Form 700 - Cover Page (2019/2020)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
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