700 Paltin 2023 Assuming Office 06/30/2023Please type or print in ink.
NAME OF FILER
1. Office, Agency, or Court
Name (Do not use acronyms)
STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
A PUBLIC DOCUMENT
(FIRST)
RECEIVE
Date Initi g eceived
JUL 17 2023 B,,,,,
CITY OF LA QUINTA
CITY CLERK DEPARTIufE
(MIDDLE)
❑ivisiori OoaPdVepartment; District, if appiicabte Your Position
► If filing for multipll positions, list below or on an attachment. (Do not use acronyms)
Agency: N� _ _ Position: &/ X
2. Jurisdiction of Office (Check at least one box)
State
❑ Multi -County
City of
❑ Judge, Retired Judge, Pro Tern Judge, or Court Commissioner
(Statewide Jurisdiction)
❑ County of
❑ Other
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2022, through ❑ Leaving Office: Date Left I I
December 31, 2022. (Check one circle.)
.or -
The period covered is I I through ❑ The period covered is January 1, 2022, through the date of
December 31, 2022. nn -or-leaving office.
X'Assuming Office: Date assumed _(r_+';V 7-07-S ❑ The period covered is I I through
the date of leaving office.
❑ Candidate: Date of Election and office sought, if different than Part 1:
�4. Schedule Summary (required) ► Total number of pages including this cover page:
Schedules attached
U 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
U Schedule B - Real Property.— schedule attached L] Schedule E - Income — Guts — Travel Payments — schedule attached
-or- i None - No reportable interests on any schedule
5. Verification - Azym-k i
MAILING ADDRESS STREET CITY S1ATE ZIP CODE
F EP ONE NUMBER EMAIL ADDRESS
( )
I have used all reasonable diligence in preparing this statement. I have reviewed this statement arA to the be6l4cf my knowla 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 Signature
(month, day, year) (File the onginaliy s;yned paper statement with your filing o'nr :),.1
FPPC Form 700 -Cover Page (2022/2023)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
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