700 RASA (Nelson) 2021STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
A PUBLIC DOCUMENT
Please type or print in ink.
NAME OF FILER (LAST) (FIRST) (MIDDLE)
t4cl'50d A� I�t
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
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Division, Board, Department, District, if applicable Your Position
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► 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
❑ Multi -County
Position:
RECEIVED
Date Initial Filing Received
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MAR 7 2022
CITY OF LA tOUINTA
TY CLERK DEPARTMU
❑ Judge, Retired Judge, Pro Tern Judge, or Court Commissioner
(Statewide Jurisdiction)
❑ County of
39Lity of `A C2%)1 ❑ Other
3. Type of Statement (Check at least one box)
Annual: The period covered is January 1, 2021, through El Leaving Office: Date Left —
r� December 31, 2021. (Check one circle.)
.or -
The period covered is _J through
December 31, 2021
❑ Assuming Office: Date assumed
❑ Candidate: Date of Election
❑ The period covered is January 1, 2021, through the date of
-or-
leaving office.
❑ The period covered is — _ , through
the date of leaving office.
and office sought, if different than Part 1:
. 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 Property - schedule attached ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached
-or-
'A None- No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
DAYTIME —TELEPHONE NUMBER
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
(month day, yoaf I — (File the originaNy signed paper statement with your fi♦ ng olfic at.j