700 Batavick 202161
Please type or print in ink.
NAME OF FILER (LAST) a
1. Office, Agency, or Court
Agency Name (Do not use acronyms) r
STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
A PUBLIC DOCUMENT
{FIRST]
Division, Board, DePa tment, Distr[cl, if appl[c&e Your Position
i L i[l l1 ` •
► If filing for multiple positions, list below or on a attachment. (Do not use acronyms)
Agency:
Position:
.(MIDDLE)
�l
RECEIVED
Date Initial Filing Received
,BAN 2'5 NZZ .
CITY OF LA QUINTA
ITY CLERK DEPARTMD
2. Jurisdiction of Office (Check at least one box)
❑ State ❑ Judge, Retired Judge, Pro Tern Judge, or Court Commissioner
(Statewide Jurisdiction)
❑ Multi -County ❑ County of
City of ❑ Other
3. Type of Statement (Check at least one box)
Annual: The period covered is January 1, 2021, through ❑ Leaving office: Date Left I
-or-
December 31, 2021. (Check one circle.)
The period covered is 1 1 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 I I through
the date of leaving office.
❑ Candidate: Date of Election and office sought, if different than Part 1:
14. 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
XSchedule B - Real Property — schedule attached
-or- ❑ None - No reportable interests on any schedule
5. Verification
0
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 STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
8 d LL+
DAY7 IME M EPNONE NUMBER MAIL ADDRESS
I have used all reasonable diligence in preparing this statement. I have reviewed t ' statem and to the best of my now ge 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.
a
® FPPC Form -2 -Cover Page .fp21/2022)
a.gov
advice�Ofppc.w.gov • 866-2753772 • 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,a a ItIrA %' rya
GENERAL bESCRIPTIO THISr BUS INESS �
FAIR MARKET VALUE
❑ $2,000 - $10,000 ❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 Over $1,000,000
NATURRE� OF INVESTMENT �..l}�
SVtS ❑Other a-
(17e-scuba)
❑ Partnership ❑ Income Received of $0 - $499
❑ Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
1 /21 /21
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
Moira axle
GENERAL D&LCRIPTION OF THIS BU NESS
:LmyeAficA Uit s hlri .ea
FAIR MARKET VALUE
. $2,000 - $10,000 [ $10,001 - $100,000
i $100,001 - $1,000,000 Over $1,000,000
NATURE OF INVESTMENT 7`
Stock Other QPJ r� .t
Partnership I_1 Income Received of $0 - $499
❑ Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
1 r21 )21
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
❑ $2,000 - $10,000 r 1 $10,001 - $100,000
❑ $100,001 - $1,000,000 1 Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other
escn e)
❑ Partnership ❑ Income Received of $0 - $499
❑ Income Received of $500 or More (Report on schedule C)
IF APPLICABLE, LIST DATE:
—I IV /21
ACQUIRED DISPOSED
Comments:
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSIN
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 El income Received of $0 - $499
❑ 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,o00,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other
(Describe)
❑ Partnership ❑ Income Received of $0 - $499
❑ Income Received of $500 or More (Report on Schedule Q
IF APPLICABLE, LIST DATE:
/21 1 /21
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,o00,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other
kL)escnF3ej
❑ Partnership ❑ Income Received of $0 - $499
❑ Income Received of $500 or More (Report on Schedule Q
4
IF APPLICABLE, LIST DATE:
i—J21— 1 /21
ACQUIRED DISPOSED
FPPC Form 700 -Schedule A-1 (2021/2022)
advlce@fppc.ca.gov - 866-275-3772 - www.fppc.ca.gov
Page - 7
NONE SCHEDULE A-2
Investments, Income, and Assets
of Business Entities/Trusts
(Ownership Interest is 10% or Greater)
1- 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 -�-J/2
$10,001 - $100,000 ACQUIRED DISPOSED
I -I $100,001 - $1,OOQ000
Over $1,000,000
NATURE OF INVESTMENT
Partnership ❑ Sole Proprietorship
Other
YOUR BUSINESS POSITION
o* 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA
SHARE OF ••SS INCOME TO THE ENTITYITRUST)
$0 - $499 U $10,001 - $100,000
$500 - $1,000 OVER $100,000
$1,001 - $10,000
P. 1 LIST THE NAME OF ►RTABLE SINGLE SOURCE OF
INCOMEOF $10,000 OR MORE
1 None or Names listed below
PROPERTY0- 4. INVESTMENTS AND INTERESTS IN REAL OR
LEASED &Y THE BUSINESS ENTITY • TRUST
-
Check one box:
❑ INVESTMENT REAL PROPERTY
Name of Business Entity, if Investment, QI
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity Qr
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. ramaining
Check box if additional schedules reporting investments or real property
are attached
Comments:
CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
Name
- L• - s_
111� 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
1 $2,000 - $10,000 JJ21- JJ21-
Lf $10,001 - $100,000 ACQUIRED DISPOSED
n $100,001 - $1,000,000
Over $1,000,000
NATURE OF INVESTMENT
Lnership ❑ Sole ProprietorshipOlher
BUSINESS POSITION
SHARE OF ••SS INCOME TO THE ENTITY/TRUST)
$0 - $499 ❑ $10,001 - $100,000
$500 - $1,000 OVER $100,000
n $1,001 - $10,000
0- 3 LIST THE NAME OF ••-TABLE SINGLE SOURCE OF
INCOMEOF r rrr OR MORE
L] 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, QL
Assessor's Parual 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 _/ 121 _J---12
$100,001 - $1,000,000 ACQUIRED DISPOSED
Over $1,000,000
NATURE OF INTEREST
Property Ownership/Deed of Trust Stock ❑ Partnership
Leasehold ❑ Other
Yrs. remaining
Check box if additional schedules reporting investments or real property
are attached
FPPC Form 700 - Schedule A-2 (2021/2022)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 9
SCHEDULE B
Interests in Real Property
(Including Rental Income)
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRE S
CITY err
Sao EA
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000 /2 --/-j2i-
❑ $100,001 - $1,000.000 ACQUIRED DISPOSED
Over $1,000,000
NATURE OF INTEREST
xOwnership/Deed of Trust ❑ Easement
I_Leasehold
Yrs. remaining Other
IF RENTAL PROPERTY, GROSS INCOME RECEIVED
❑ $0 - $499 ❑ $500 - $1,000 X$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
che16y1. Moore. (Jaa5�illlffr
and Pop tivare
Name
► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
CITY
d
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
❑ 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
* 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 (2021/2022)
advice@lfppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page -11
NoNE SCHEDULE C
Income, Loans, & Business
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
(Reel property, car, boat etc.)
❑ Loan repayment
❑ Commission or ❑ 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 - $1o,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-empioyad use Schedule A-2.)
❑ Partnership (Less than 10% ownership. For 10% or greater use
Schedule A-2.)
❑ Sale of
(Real property; car, boat, etc.)
❑ Loan repayment
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
(Describe) (Describe)
❑ Other ❑ Other
(Describe) (Describe)
1- 2, LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD
* 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' INTEREST RATE TERM (Months/Years)
❑ None
ADDRESS (Business Address Acceptable)
SECURITY FOR LOAN
BUSINESS ACTIVITY, IF ANY, OF LENDER ❑ None ❑ Personal residence
❑ Real Property
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1,000
❑ $1,001 - $10,000
❑ $10,001 - $100,000
❑ OVER $100,000
Comments:
❑ Guarantor
❑ Other
Street address
City
(Describe)
FPPC Form 700 -Schedule C (2021/2022)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page -13
NfDNE
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)
��— 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)
/�— $
—J�— $
► 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)
$
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 (mmldd/yy) VALUE DESCRIPTION OF GIFT(S)
► NAME OF SOURCE (Not an Acronym)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
DATE (mmldd/yy) VALUE DESCRIPTION OF GIFT(S)
$
$
FPPC Form 700 - Schedule D (2021/2022)
advice@fppc.a.gov • 866-275-3772 • www.fppc.a.gov
Page - 15
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.
I. 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):_-- /--/— - /--I— AMT-.!
(if gam)
► MUST CHECK ONE: ❑ Gift -or- ❑ Income
❑ Made a Speech/Participated in a Panel
❑ Other - Provide Description
P. 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 - AMT-. 5
(If gift)
► MUST CHECK ONE: ❑ Gift -or- ❑ Income
Made a Speech/Participated in a Panel
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— AMT. $
(If gift)
► MUST CHECK ONE: ❑ Gift -or- ❑ Income
_j Made a Speech/Participated in a Panel
❑ Other - Provide Description
► If Gift, Provide Travel Destination
No. 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--JAMT: $
(If gift)
► MUST CHECK ONE: ❑ Gift -or- ❑ Income
❑ Made a Speech/Participated in a Panel
Other - Provide Description
► If Gift, Provide Travel Destination
FPPC Form 700 - Schedule E (2021/2022)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page -17