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Form 700 RASA 2019 (Nelson)• - • _ 0 STATEMENT OF ECONOMIC INTERESTS Date IniIIYFIF1iN , FAIR POLITICAL PRACTICES COMMISSION ''ceived CALIFCOVER PAGE JUN 5 P019 Please type or print in ink. A PUBLIC DOCUMENT CITY() NAME OF FILER (LAST) LA QIAIYTA Nelson (FIRST) Eric Alan 1. Office, Agency, or Court Agency Name (Do not use acronyms) Development Services Division, Board, Department, District, if applicable Your Position Public Works — Acting City Land Surveyor ► If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: _ _ Position: 2. Jurisdiction Of Office (Check at least one box) ❑ State ❑ Multi -County ❑X City of La Quinta 3. Type of Statement (check at least one box) ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ County of ❑ Other ❑X Annual: The period covered is January 1, 2018, through . December 31, 2018. -or- ❑Leaving Office: Date Left —J—/ (Check one circle.) De period covered is �J�I through O The period covered is January 1, 2018, through the date of December 31, 2018. -or- leaving office. IJ Assuming Office: Date assumed _ �� O The period covered is �J � ,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 C - Income, Loans, & Business Positions — schedule attached ❑ Schedule A-2 - Investments — schedule attached ❑ Schedule D -Income —Gifts —schedule attached ❑ Schedule B - Real Plaperty — schedule attached ❑ Schedule E - Income - Gifts — Travel Payments — schedule attached ,Or, © None - No reportable interests on any schedule 5. Verification I-LiNO ADDRESS STREET (Business or Agency Address Recommended - Public Document) CITY 534 Rancho Terr Escondido DAYTIME TELEPHONE NUMBER ( 760 ) 738-8709 CODE CA 92026 EMAIL ADDRESS Eric.N.Rasa@gmail.com 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. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date Signed 06/03/2019 r (month, day, year) Signature (File the originally signed paper statement with your6ling oKcial) FPPC Form 700 (2018I2019) FPPC Advice Email: advlce@lfppc.ca.gov FPPC Toll -Free Helpline: 8661275.3772 www.fppc.ca.gov Page-5