700 Gray 2022 ElectionRECEIVED
STATEMENT OF ECONOMIC INTERESTS
CALIFORNIA FORm7OO FAIR POLITICAL PRACTICES COMMISSION COVER PAGE
-�, A PUBLIC DOCUMENT
Please type or print in ink.
Date U ss \NM``� ved - (� _
CITY OF LA OUINTA
CRY CLERK DEPARTMENT
NAME OF FILER (LAST) [E r (M I
r
1. Office, Agency, or Court
Aggncy Name ((o n use a�� nyms)
01� u: II&1,11'c
Division Poard Department District if applicable Your Position
Ci.�4 C10 uAGi'
► if filing r multiple positions, list below or on an attachment. (Do not use acronyms)
Agency: A�I., ± _ Position:
2. Jurisdiction of Office (Check at least one box)
State
C 61, A�� � It'Jq-
Judge, Retired Judge, Pro Tern Judge, or Court Commissioner
(Statewide Jurisdiction)
MultkCounty _ County of
4 of / Other
3. Type of Statement (Check at least one box)
Annual: The period covered is January 1, 2021, through Leaving Office: Date Leff I I
- December 31, 2021. (Check one circle.)
-or-
The period covered is —J— I through The period covered is January 1, 2021, through the date of
December 31, 2021, -or-
leaving office.
Assuming Office: Date assumed I I The period covered is 1 1 through
1 the date of leaving office.
y Candidate: Date of Election 4� 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- VNane - No reportable interests on any schedule
5. Verification
Schedule C - Income, Loans, & Business Positions — schedule attached
Schedule D - Income — Gifts — schedule attached
Schedule E - Income — Gifts — Travel Payments — schedule attached
MAILING ADDRESS STREET CITY
(Business or AgwW Aft -ass Recommended - Public J �f
Gllll'r
DA M1 TELEPHONE NUMBER E&WLADDRESS
STATE ZIP CODE
-& � -
I have used all reasonable diligence in preparing this statement I have reviewed this statem and t e est of my knowledge the information contained
herein and in any attached schedules is true and complete. I acknowledge this is a public documen .
I certifv under penalty of oeriury under the laws of the State of California that the foregoing is true and correct.
FPPC Form 700 -Cover Page (2021/2072)
advice@fppc-ca.gov - 866-275.3772 - www.fppc.ca.gov
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