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700 Batavick 2020Please type or print in ink. NAME OF FILER (LAST) 1. Office, Agency, or Court Agency Name (Do not use acronyms) STATEMENT OF ECONOMIC INTERESTS COVER PAGE A PUBLIC DOCUMENT (FIRST) (MIDDLE) RECEIVED Date Initial Filing Received CITY OF LA 0JINTA Division, Board, Departot, District, if *pricable Your Position 0.me-luber A *US JJ ► If filing for multiple positions, list below or on an attachmen . o not use acronyms) Agency: 2. Jurisdiction of Office (Check at least one box) ❑ State ❑?'City ti-County of Position: ❑ Judge, Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction) ❑ County of � AR-ji ❑ Other 3. Type of Statement (Check at least one box) Vnnual: The period covered is January 1, 2020, through December 31, 2020. .or - The period covered is I I through December 31, 2020. ❑ Assuming Office: Date assumed J. ❑ Leaving Office: Date Left (Check one circle.) O The period covered is January 1, 2020, through the date of -or- leaving office. O 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 (must complete) ► Total number of pages including this cover page: 7 Schedules attached [ chedule A-1 - Investments — schedule attached I of Schedule A-2 - Investments — schedule attached [Schedule B - Real Property— schedule attached -or- ❑ None - No reportable interests on any schedule 5. Verification MAILING ADDRESS (Business or Agency Address ochedule C - Income, Loans, & Business Positions — schedule attached EiKSchedule D - Income — Gifts — schedule attached Ei Schedule E - Income — Gifts — Travel Payments — schedule attached STREET CITY STATE ZIP CODE 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 information contained 9ffocial.l FPPC Form 700 - Cover Page (202012021) advice@fppc.ca.gov - 866-275-3772 - www.fppc.ca.gov Page - 5 SCHEDULE A-1 Investments Stocks, Bonds, and Other Interests (Ownership Interest is Less Than 10%) Investments must be itemized. Do not attach brokerage or financial statements. ► NAME OF BUSINESS ENTITY !T�e- Vahuu&a GENIEFfAL DESCRiPTI F THIS BUSINESS )UVLSt-V CD. FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 �Y/Over $1,000,000 NATURE OF INVESTMENT Stock ❑ Other �������� Jr" (De5cnba) ❑ Partnership Q Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY M, a tra.4.) S-- ti.! EU GENERAL D RIPTION OF THIS Busvess FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 WOver $1,000,000 NATURE OF INVESTMENT ' Stock Other IW J 4 l�AI b'"11 Ski (De cribs) ❑ Partnership O Income Received of $0 - $499 K a7 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: __j—J20 1 /20 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other ( scn ) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED Comments: ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE ❑ $2,000 - $10,000 [ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: 120 / /20 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,00, - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on schedule C) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other escnoa ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on schedule C) IF APPLICABLE, LIST DATE: �/20- —J 120 ACQUIRED DISPOSED FPPC Form 700 -Schedule A-1(2020/2021) advice@fppc.ca.gov • 866-275-3772 • wwwJppc.ca.gov Page - 7 SCHEDULE A-2 Investments, Income, and Assets of Business Entities/Trusts (Ownership Interest is 10% or Greater) P- 1. BUSINESS ENTITY OTRUST R Name Address (Business Address Acceptable) Check one ❑ Trust, go to 2 ❑ Business Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $0 - $1,999 ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ACQUIRED DISPOSED ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Partnership ❑ Sole Proprietorship ❑ Other YOUR BUSINESS POSITION SHARE OF ••SS INCOME TO THE ENTITY/TRUST) ❑ $0 - $499 ❑ $10,001 - $100,000 ❑ $500 - $1,000 ❑ OVER $100,000 ❑ $1,001 - $10,000 O3. LIST THE NAME OF •RTABLE SINGLE SOURCE OF ❑ None or L] Names listed below PROPERTY4. INVESTMENTS AND INTERESTS IN REAL OR LEASED R.Y THE BUSINESS ENTITY OR Check one box: ❑ INVESTMENT ❑ REAL PROPERTY Name of Business Entity, if Investment, gil Assessor's Parcel Number or Street Address of Real Property Description of Business Activity gr City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OF INTEREST ❑ Property Ownership/Deed of Trust ❑ Stock ❑ Partnership ❑ Leasehold ❑ Other Yrs. remalninp ❑ Check box if additional schedules reporting investments or real property are attached Comments: CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION .o. 1- BUSINESS ENTITY OTRUST R Address (Business Address Acceptable) Check one ❑ Trust, go to 2 ❑ Business Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $0 - $1,999 ❑ $2,000 - $10,000 /20 ❑ $10,001 - $100,000 ACQUIRED DISPOSED ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Partnership ❑ Sole Proprietorship ❑ Other YOUR BUSINESS POSITION SHARE OF ••SS INCOME TO THE ENTITY/TRUST) ❑ $0 - $499 ❑ $10,001 - $100,000 ❑ $500 - $1,000 ❑ OVER $100,000 ❑ $1,001 - $10,000 0- 3, LIST THE NAME OF ••-TABLE SINGLE SOURCE OF ❑ None or ❑ Names listed below • INTERESTS IN REAL PROPERTY• OR LEASED BY THE BUSINESS ENTITY • TRUST - Check one box: []INVESTMENT ❑ REAL PROPERTY Name of Business Entity, if Investment, gi Assessor's Parcel Number or Street Address of Real Property Description of Business Activity prr City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 /20 --j--j2O ❑ $100,001 - $1,000.000 ACQUIRED DISPOSED ❑ Over $1,000,000 NATURE OF INTEREST ❑ Property Ownership/Deed of Trust ❑ Stock ❑ Partnership ❑ Leasehold ❑ Other Ym. mmalning ❑ Check box if additional schedules reporting investments or real property are attached FPPC Form 700 -Schedule A-2(2020/2021) advice@fppc.ca.gov • 966-275-3772 • www.fppc.ca.gov Page - 9 SCHEDULE B Interests in Real Property (Including Rental Income) ► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS A v CITY S c>t.IN apx�.0up , � FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 $10,001 - $100,000 /20 -j-j2(- $100,001 - $1,000,000 ACQUIRED DISPOSED Over $1,000,000 NATURE OF INTEREST ❑ Ownership/Deed of Trust ❑ Easement ❑ Leasehold ❑ Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 SOURCES OF RENTAL INCOME: If you own a 10% or greater interest, list the name of each tenant that is a single source of income of $10,000 or more. ❑ None C'�►� N� v ��c (dau A - VC cvu ► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS CITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INTEREST ❑ Ownership/Deed of Trust IF APPLICABLE, LIST DATE: -j-j2D- ---J-JZQ- ACQUIRED DISPOSED ❑ Easement ❑ Leasehold ❑ Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 SOURCES OF RENTAL INCOME: If you own a 10% or greater interest, list the name of each tenant that is a single source of income of $10,000 or more. ❑ None * You are not required to report loans from a commercial lending institution made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows: NAME OF LENDER' ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER INTEREST RATE % ❑ None TERM (Months/Years) HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 ❑ Guarantor, if applicable Comments: NAME OF LENDER' ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER INTEREST RATE % ❑ None TERM (Months/Years) HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 ❑ Guarantor, if applicable FPPC Form 700 -Schedule B (2020/2021) advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov Page -11 NMc, SCHEDULE C Income, Loans, 8Business Positions (Other than Gifts and Travel Payments) NAME OF SOURCE OF INCOME ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ No Income - Business Position Only ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.) ❑ Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.) ❑ Sale of ❑ Loan repayment ❑ Commission or (Real property, car, boat etc.) ❑ Rental Income, list each source of $10,000 or more NAME OF SOURCE OF INCOME ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ No Income - Business Position Only ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's or registered domestic partner's income (For self-employed use Schedule A-2 ) ❑ Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.) ❑ Sale of ❑ Loan repayment ❑ Commission or (Real property; car, boat, etc.) ❑ Rental Income, list each source of $10,000 or more (Describe) ❑ Other — ❑ Other (Describe) (Describe) o. 2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PER10D * You are not required to report loans from a commercial lending institution, or any indebtedness created as part of a retail installment or credit card transaction, made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows: NAME OF LENDER' ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 Comments: INTEREST RATE TERM (Months/Years) % ❑ None SECURITY FOR LOAN ❑ None ❑ Personal residence ❑ Real Property ❑ Guarantor ❑ Other Street address city (Describe) FPPC Form 700 - Schedule C (2020/2021) advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov Page -13 C) tj SCHEDULE D Income - Gifts ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) ��- $ ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) ��- $ $ ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) $ Comments: ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) $ $ ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) $ ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE (mm/dd/yy) VALUE DESCRIPTION OF GIFT(S) ��- $ FPPC Form 700 - Schedule D (2020/2021) advice@fppc.ca.gov • 866-275-3772 • wwwJppc.ca.gov Page -15 No �E SCHEDULE E Income — Gifts Travel Payments, Advances, and Reimbursements • Mark either the gift or income box. • Mark the "501 (c)(3)" box for a travel payment received from a nonprofit 501 (c)(3) organization or the "Speech" box if you made a speech or participated in a panel. Per Government Code Section 89506, these payments may not be subject to the gift limit. However, they may result in a disqualifying conflict of interest. • For gifts of travel, provide the travel destination. ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) CITY AND STATE ❑ 501 (c)(3) or DESCRIBE BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE(S):--/---]— - AMT: F (if gift) ► MUST CHECK ONE: ❑ Gift -or- ❑ Income O Made a Speech/Participated in a Panel p Other - Provide Description ► If Gift, Provide Travel Destination ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) CITY AND STATE ❑ 501 (c)(3) or DESCRIBE BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE(S):--J--J_ • AMT $ (If gA) ► MUST CHECK ONE: ❑ Gift -or- ❑ income O Made a Speech/Participated in a Panel Q Other - Provide Description ► If Gift, Provide Travel Destination Comments: ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) CITY AND STATE ❑ 501 (c)(3) or DESCRIBE BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE(S):--J—J— - —J--J— AMT. S— (if gam) ► MUST CHECK ONE: ❑ Gift -or- ❑ Income O Made a Speech/Participated in a Panel p Other - Provide Description ► If Gift, Provide Travel Destination ► NAME OF SOURCE (Not an Acronym) ADDRESS (Business Address Acceptable) CITY AND STATE ❑ 501 (c)(3) or DESCRIBE BUSINESS ACTIVITY, IF ANY, OF SOURCE DATE(S):--J--I— - —I�— AMT., c_ (if gffl) ► MUST CHECK ONE: ❑ Gift -or- ❑ Income O Made a Speech/Participated in a Panel Q Other - Provide Description ► If Gift, Provide Travel Destination FPPC Form 700 - Schedule E (2020/2021) advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.90v Page - 17