HomeMy WebLinkAboutStrong, MalakaiPUBLIC INTEGRITY DISCLOSURE REPORT
Name (Print last, first, middle initial) E-mail Address
Position/Title
Address
Work Phone Reporting Status
New Official
Annual
Update
If New Official, Date of Election or
Appointment:
(mm/dd/yy)
Reportable Information – Every official shall disclose each and all of his/her interests,
wherein he/she serves as a voting member of a board of directors of a non-profit entity without
compensation, as an attorney or accountant for such an entity who provides pro bono services,
or as the trustee of a charitable trust.
Organization:
(include the address, city and state where the the organization is located)
Type of organization: Position: No
longer
held:
1 Voting Board Member
Attorney
Accountant
2 Voting Board Member
Attorney
Accountant
3 Voting Board Member
Attorney
Accountant
4 Voting Board Member
Attorney
Accountant
5 Voting Board Member
Attorney
Accountant
6 Voting Board Member
Attorney
Accountant
Check here if additional pages attached.
Reportable Information – Every official shall disclose each and all of his/her rented or leased
interests in real property located in the City of Palm Springs. This disclosure shall include
leases executed with the Agua Caliente Band of Cahuilla Indians in relation to real property
that you own.
Property Address: Type of Property:
Term of Rental
Agreement/
Lease:
No
longer
held:
1 Home/Residence
Business/Commercial
Investment/Other
2 Home/Residence
Business/Commercial
Investment/Other
3 Home/Residence
Business/Commercial
Investment/Other
4 Home/Residence
Business/Commercial
Investment/Other
5 Home/Residence
Business/Commercial
Investment/Other
6 Home/Residence
Business/Commercial
Investment/Other
I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF
CALIFORNIA THAT THE FOREGOING IS TRUE AND CORRECT.
Signature of Disclosing Party Date
On the basis of information contained in this report, I conclude that the filer is in compliance
with Palm Springs Municipal Code Section 2.60, except as noted in the “comments” box below.
Comments:
Signature and Title of Agency’s Final Reviewing Official
Check here if additional pages attached.
CITY OF PALM SPRINGS
PUBLIC INTEGRITY DISCLOSURE
Why Must I File?
Your position requires you to file this Public Integrity Disclosure Form regarding potential
conflicts of interest you might have under Palm Springs Municipal Code Chapter 2.60. This form
will assist you in identifying and avoiding conflicts between official duties on the one hand, and
other legal duties you have, or conflicts arising from real property that you rent or lease on the
other hand. The information you provide will become a public record (with the exception of your
for all elected officials. Some information required by this form may also be required in your
Form 700. Please ensure that the information you provide is complete and accurate.
When Must I File?What is the Reporting Period?
New Official:
The report is due within 30 days of your assuming a
position designated for filing, unless the City
requests the report earlier or grants you a filing
extension.
Report the required information for the 12 months
preceding your filing of this form.
Annual Filer:
The report is due no later than the end of the first
business day of the month of April, unless the City
grants you an extension.
Report the required information for the preceding
calendar year (January 1 through December 31).
Semi-Annual Filer:
The semi-annual update is due no later than the end
of the first business day of the month of August. A
semi-annual update shall be filed only if the public
official experienced a material change of interest
after filing a form pursuant to PSMC 2.60.040,
subdivision (A)or (B), or as to any interest identified
in that official's most recent Form 700.
The semi-annual update covers the period of
January 1 through June 30.
Should you have any questions regarding the completion of this form, please do not hesitate to contact
the Office of the City Clerk via email at cityclerk@palmspringsca.gov.