700 Gaeta-Mejia 2019RECEIVED
STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
Please type or print in ink. A PUBLIC DOCUMENT
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CITY OF LA QUINTA
CITY CLERK DEPARTMENT
NAME OF FILER (LAST) IFIR57) (MIDDLE)
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1. Office, Agency, or Cotlit
Agency Name (Do not use acronyms)
Division, Board, Department, District, if applicablb 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
Position
❑ Judge, Retired Judge, Pro Tem Judge, or Court Commissioner
(Statewide Jurisdiction)
❑ Multi -Coup ❑ County of
City of ❑ Other
3. Type of Statement (Check at least one box)
_L- Annual: The period covered is January 1, 2019, through
December 31, 2019.
-or-
The period covered is
December 31, 2019.
❑ Assuming Office: Date assumed J— I
❑ Candidate: Date of Election
❑ Leaving Office: Date Left I
(Check one circle.)
through O The period covered is January 1, 2019, through the date of
-or-
leaving office.
O 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: T
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
MAILING AUURESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
-'? St4C((!Cote i w� ��_� L" u� C
DAYTIME TELEPHONE NUMBER EMAIL ADDRESS
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to a best of my knowledge th ' formation contained
herein and in any attached schedules is true and complete. I acknowledge this is a public document.
certify under penalty of perjury under the laws of the State of California that the foregoing is true nd correct.
Date Signed I i _ Signature
(month, day, year) (File the originally signed paperstate fh your filing official.)
FPPC Form 700 - Cover Page (2019/2020)
advice@fppc.ca.gov - 866-275-3772 - www.fppc.ca.gov
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