700 Lagunas, Dana 2022 Assuming Office 05.23.2022STATEMENT OF ECONOMIC INTERESTS KCEIP Utceived
COVER PAGE Filing Official Use Only
A PUBLIC DOCUMENT MAY 2 6 2022 c�...
Please type or print in ink. CITY OF LA GIUINTA
NAME OF FILER (LAST) (FIRST) (MIDDLE} MIT
LA guhaS 'Patna
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
C (� o f La Q W A-6k Sr. E Irv, e r
Division, Board, Department, District, if applicable Your Position
► 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
✓City of L A Q t,.liv%ka
3. Type of Statement (Check at least one box)
Annual: The period covered is January 1, 2021, through
December 31, 2021.
-or-
The period covered is I I through
December 31, 2021.
kAssumin Office: Date assumed 51 2 3 1 20 2 Z
` 9O=
Candidate: Date of Election
Position:
MaNa9.P_M0-v L COo rAiyiq-bO —
Judge, Retired Judge, Pro Tern Judge, or Court Commissioner
(Statewide Jurisdiction)
County of
Other
Leaving Office: Date Left
(Check one circle.)
The period covered is January 1, 2021, through the date of
-or-
leaving office.
The period covered is I I 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:
Schedules attached
Schedule A-1 - Investments — schedule attached Schedule C - Income, Loans, & Business Positions — schedule attached
Schedule A-2 - Investments — schedule attached Schedule D - Income — Gifts — schedule attached
Schedule B - Real Property — schedule attached Schedule E - Income — Gifts — Travel Payments — schedule attached
-or- ✓None - No reportable interests on any schedule
5. Verification 115114
ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
DAYTIME TELEPHONE NUMBER ^ EMAILADDRESS
( 615 V
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 5 Z 5 �-0 2 Signature
(Mort . day, year) fRia the wtpina@y signed paper slaternk witty 6f ng aficW)
FPPC Form 700 - Cover Page (2021/2022)
advice@fppc.ca.gov • 866-275-3772 • wwwJppc.ca.gov
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