460 Henderson 2013 from 07/01 -12/31Rec'r ,',den Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink. Date stamp
1014 JEi 1 28
Statement covers period Date of election if applic@olk u I 1.
07/01/13 (Month, Day, Year from
, r
from VITY` LER' S' ,)i F IGE
through
12/31/13
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) Q 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.D. NUMBER
1349748
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Terry Henderson for Mayor 2012
4.
STREET ADDRESS (NO P.O. BOX)
54711 Eisenhower Dr.
CITY STATE ZIP CODE AREA CODE/PHONE
La Quinta CA 92253 760-564-3044
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
760-564-2925
11/06/12
COVER
Page _J_ of
For Official Use Only
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
Richard L. Jandt
MAILING ADDRESS
54711 Eisenhower Dr.
CITY STATE ZIP CODE AREA CODE/PHONE
La Quinta CA 92253 760-564-3044
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
760-564-3044/richardjandt@aol.com
Verification
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 foregoing is true and co rect.
Executed on /Z-7 h By
D' e f lure ofre urerorAssistantTreasurer
Executed on �` ByL'%
Date RI—h— of rs lin Offi hMd.rr—Hid,f,q},}o Menc„ro Prnnnnon}nr Po¢n ihlo r)ffiror of q-1—
Executed on
Date
By
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent
FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
State of California