460 Pena 2014 from 10/01 to 10/18Recipnt Cpmmittee
COVEF
Cam fta gWS- tatement
Type or print in ink.
Date Stamp
• -
RECEIVED
Cover Page
CIT
CLERK'S OFFICE
1. i
(Government Code Sections 84200.84216.5)
CITY
STATE
ZIP CODE
R
r
Statement covers period Date of election if applicable:
92253
(760)564-4184
10/1/2014
from
(Month, Day, Year) 7(;([
= 1
(^
CTT 23 AM Ip: 78
Page of
For Official Use Only
SEE INSTRUCTIONS ON REVERSE
through 10/18/2014
11/4/2014 GIT
OF LA QUINTA
AI IFORMIA
1. Type of Recipient Committee: An committees - complete Parts 1, 2, 3, and 4.
2. Type of Statement:
® Officeholder, Candidate Controlled Committee
❑ Ballot Measure Committee
® Preelection Statement
❑Quarterly Statement
Q State Candidate Election Committee
Q Recall
Q Primarily Formed
E]Semi-annualStatement
❑ Special Odd -Year Report
(Also Complete Parts)
Q Controlled
Q Sponsored
❑ Termination Statement
L] Supplemental Preelection
(Also Complete Perte)
❑ Amendment (Explain below) Statement - Attach Form 495
❑ General Purpose Committee
Q Sponsored
❑ Primarily Formed Candidate/
0 Small Contributor Committee Officeholder Committee
0 Political Party/Central Committee
(Als000mpletePart7)
3. Committee Information
UVMMII IEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
COMMITTEE TO ELECT JOHN PENA CITY COUNCIL 2014
STREET ADDRESS (NO P.O. BOX)
51405 CALLE HUENEME
WAlt LIF ODUE AREA CODE/PHONE
LAQUINTA CA 92253 (760)564-4184
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
4. Verification
Treasurer(s)
NAME OF TREASURER
-
CHRIS McCULLOUGH
MAILING ADDRESS
51405 CALLE HUENEME
CITY
STATE
ZIP CODE
AREA CODE/PHONE
LAQUINTA
CA
92253
(760)564-4184
NAME OF ASSISTANT TREASURER, IF ANY
PAULA HELD
MAILING ADDRESS
51405 CALLE HUENEME
CITY
STATE
ZIP CODE
AREA CODE/PHONE
LAQUINTA
CA
92253
(760)564-4184
OPTIONAL: FAX / E-MAIL ADDRESS
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained 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 foregoinq)s-kue apAkoorrect. , I
Executed on ^ /22- / / 41
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Executed on IOZI-"%DT/�- I '^' I/A�
T
Datd
Executed on
Date
Executed on
Date
By
By
By
Slgnalure of Controlling OfioeMWer, Cantlitlale,SWte Measure Proponent FPPC Form 460 (June/01)
FPPC Toll -Free Helpline:-866/ASK-FPPC.
State of California