700 Blakeley 2021CALIFORNIA FORM700
FAIR POLITICAL PRACTICES COMMISSION
Please type print in ink
1. Office, Agency, or
Agency Name (Do not use acronyms)
STATEMENT OF ECONOMIC INTERESTS f Date IniitialCFEng RDeived
COVER PAGE Fir. ° `tom cnl
A PUBLIC DOCUMENT JAN � 5 2012 4-
(FIRST)
(MIDDLE)
Division, Board, Department, District, if applicabl
Your Positio
C��below
l�!%
► If filing for multiple positions, lor on an a ment. (Do not use acronyms)
Agency:
2. Jurisdiction of Office (Check at least one box)
—1 State
Position.
�II CITY OF LA QUINTA
I_rV nl r_!MI/ nrne nr.. r=.
_. - I vim._. — — n1 a I IVI
] Judge, Retired Judge, Pro Tem Judge, or Court Commissioner
(Statewide Jurisdiction)
] Multi -County
County of
] City of
L_ Other
3. Type of Statement II at least one box) —
Annual: The period covered is January 1, 2021, through J,
December 31, 2021. Leaving Office: Date Left
-or- (Check one circle.)
The period covered is :� through El The period covered is January 1, 2021, through the date of
December 31, 2021. leaving office,
-or-
Assuming Office: Date assumed ^J—I� ❑ The period covered is _`�
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 pager
Schedules attached
Schedule A-1 - Investments — schedule attached 4Schedule C - Income, Loans, & Business Positions — schedule attached
] Schedule A-2 - Investments — schedule attached Schedule D - Income — Gilts — 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 .
CITY �+Z�
(Business or Agency Address Recommended - Public Documerd) STATE IP C DE
aAYTIME TELEPHONE NUMBER EMAIL ADDRESS
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my ledge 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 for g is true and correct.
Date Signed _ lam.7 Signature '
rmontn, day, yearj the on na gr !fy signed papersrate It wdh your firing alfirr .
- FPPC Form 700 - Cover page I Z021/2022)
advice@fppc.ca.gov - SN-275-3772 - www.fppc.ca.gov
Page - 5
b.
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.
rvriMt Ur SINESS ENTITY 40
GENERAL DESCRIPTION OF THI BUSINE
e
FAIR MARKET VALUE
[-] $2,000 - $10,000 ❑ $10,001 - $100,000
El $100,001 - $1,000,000 [] 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 C)
IF APPLICABLE, LIST DATE:
---.1_—j2 1 J12J--
ACQUIRED DISPOSED
■ NAME OF BUSINESS ENTITY
4— i
GENERAL DESCRIPTION OF THIS
FAIR MARKET VALUE
[�] $2,000 - $10,000 [ ! $10,001 - $100,000
[l $1o0,001 - $1,000,00o Fj Over $1,00o,000
NATURE OF INVESTMENT
ID Stock Other
(Describe)
J Partnership ❑ 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
0 $2,000 - $10,000 r] $10,001 - $100,000
$100,001 - $1,000,000 Over $1,000,0oo
NATURE OF INVESTMENT
Stock L I Other
escrlaE )
Partnership [I Income Received of $0 - $499
- Income Received of $Soo or More (Report on Schedule c)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
Comments:
rvriMt Ur BUSINESS ENTITY
ENERAL 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
L_ Stock n Other
f r'ss::ri be i
Partnership Income Received of $0 - $499
Income Received of $5o0 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
—J_ /21
ACQUIRED DISPOSED
rvHnnt OF BUSINESS ENTITY
GENERAL DESCRIPTION OF TH1S BUSINESS
FAIR MARKET VALUE
$2,000 - $10,000 $10,001 - $100,000
L $100,001 - $1,000,000 L 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 C)
IF APPLICABLE, LIST DATE:
�— -j2— 1— —J_l21
ACQUIRED DISPOSED
NA[vit Ur BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
$2,000 - $10,000 $10,001 - $100,000
L. $100,001 - $1,000,000 Over $1,000,000
NATURE OF INVESTMENT
Stock Other
[ Partnership [J Income Received of $0 - $499
❑ Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
�I�i21 —�—i11
ACQUIRED DISPOSED
FPPC Form 700-ScheduleA-1 (2021/20Z2)
advice@fppc.c.a.gov . BW775.3772 - www.fppc.ca.gov
Page - 7
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 n No Income -Business Position Only
$500 - $1,000 r� $1,001 - $10,000
$10,001 - $100,000 OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Ej Salary ❑ Spouse's or regis%ered 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
(Real 11 property, car, boat, etc.)
Loan repayment
Commission or E] Rental Income, fist each source of $10,000 or more
E] Other
(Descnbe)
(Descnhe)
Name
Sharrell Blakeley
NAME OF SOURCE OF INC❑
ADDRESS (Business ress Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
:7',KK -
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED No Income - Business Position Only
$500 - $1,000 ❑ $1,001 - $10,000
X$10,001 - $100,000 ❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Salary Spouse's or registered domestic earner's income
(For self-employod use Schedule A-2 )
Partnership (Less than 10% ownership. For 10% or greater use
Schedule A-2.)
[j Sale of _
(Real property, car, boat, etc.)
Loan repayment
[] Commission or Rental Income, list each source of $10,000 or more
lDe �
. Other �?L.S� fy�J
(Descn7ye)
* 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
E] OVER $100,000
Comments:
INTEREST RATE TERM (Months/Years)
0/1 11 None
SECURITY FOR LOAN
D None D Personal residence
❑ Real Property
0 Guarantor _
[_] Other
Street address
City
(Describe)
FPPC Form 700 -Schedule C (2021/2022)
advice@fppc.w.gov • 86&275-3772 • www.fppc,Ca,gav
Page -13