700 Berumen 2021STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
A PUBLIC DOCUMENT
Please type or print in ink.
NAME OF FILER (LAST) (FIRST) (MIDDLE)
Berumen Alfred Jason
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of La Quinta
Division, Board, Department, District, if applicable
Public Works
Your Position
Management 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
[0 City of La Quinta
3. Type of Statement (Check at least one box)
�i Annual: The period covered is January 1, 2021, through
December 31, 2021.
-or-
The period covered is I I
December 31, 2021.
Assuming Office: Date assumed —J— I
Candidate: Date of Election
Position:
RECEIVED
Date Initial Filing Received
Uss Only
I- E8 17 2022 0
CITY OF LA QUINTA
L_ Judge, Retired Judge, Pro Tern Judge, or Court Commissioner
(Statewide Jurisdiction)
F_ County of
E Other
E: Leaving Office: Date Left I I
(Check one circle.)
through -1 The period covered is January 1, 2021, through the date of
leaving office.
.or-
E The period covered is I I through
the date of leaving office.
and office sought, if different than Part 1:
Schedule Summary (must complete) P. Total number of pages including this cover page:
Schedules attached
L Schedule A-1 - Investments - schedule attached
J Schedule A-2 - Investments - schedule attached
Schedule B - Real Property - schedule attached
-or- it None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY
(Business or Agency Address Recommended - Public Document)
`I Schedule C - Income, Loans, & Business Positions - schedule attached
F] Schedule D - Income - Gifts - schedule attached
El Schedule E - Income - Gifts - Travel Payments - schedule attached
STATE ZIP CODE
78-495 Calle Tampico La Quinta Ca 92253
DAYTIME TELEPHONE NUMBER _'[EMAILADDRESS
( 760 ) 777-7000 aberumen@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 public document. ,1
I certify under penalty of perjury under the laws of the State of California that the
Date Signed 02-17-2022 Signature
(month, day, year)
paper sfaferflml with yourging
FPPC Form 700 - Cover Page (2021/2022)
advice@fppc.ca.gov - 866-275-3772 - www.fppc.ca.gov
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