460 Osborne 2014 from 07/01 - 12/31Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
CITY C! E
statement covers period Date of election if applicable:
from 07/01/14 (Month, Day?[WFEB -
through
COVER PAGE
V Date Stamp CALIFORNIA , 4
�D. i
IS OFFICE FORM
f' Page —I—of
PH 12• W 3 For Official Use Only
12/31/14I 11/02/01TY OFLLA QUINTA
..... i Are ktt®
1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4.
® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure
Q State Candidate Election Committee Committee
Q Recall Q Controlled
(Also Complete Part 5) O Sponsored
(Also Complete Part 6)
❑ General Purpose Committee
Q Sponsored
Q Small Contributor Committee
Q Political Party/Central Committee
❑ Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 7)
3. Committee Information I I.D. NUMBER
1348544
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
COMMITTEE TO ELECT LEE OSBORNE FOR LA QUINTA CITY
COUNCIL
STREET ADDRESS (NO P.O. BOX)
79245 CORPORATE CENTRE DR, #101
CITY STATE ZIP CODE AREA CODE/PHONE
LA QUINTA CA 92253 760-777-9805
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODE/PHONE
NAL: FAX / E-MAIL ADDRESS
2. Type of Statement:
❑ Preelection Statement ❑ Quarterly Statement
® Semi-annual Statement ❑ Special Odd -Year Report
❑ Termination Statement ❑ Supplemental Preelection
(Also file a Form 410 Termination) Statement -Attach Form 495
❑ Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
PEDRO RINCON
MAILING ADDRESS,
79245 CORPORATE CENTRE DR, #101
CITY STATE ZIP CODE AREA CODE/PHONE
LA QUINTA CA 92253 760-777-9805
NAME OF ASSISTANT TREASURER, IF ANY
LING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the infor ntained herein and in the attached schedules is true and complete. I certify
under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on / �4 BY
Date gignature of Treasurer or Assistant Treasurer
Executed on BY
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor
Executed on BY
Date Signature of Controlling Officeholder, Candidate, Stale Measure Proponent
Executed on BY
Date Signature ofControlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
State of California