460 Henderson 2013 from 01/01 - 06/30Recipient Committee
Campa19n Statement
Clever kage
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period
from 01/01/13
through 06/30/13
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
4.
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Terry Henderson for Mayor 2012
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
Fax 760-564-3044
Date of election if appli
(Month, Day, Year)
17rn+ 1\ c_ ;)
_ 1Date StRmp
{ W
11/06/12 1
2. Type of Statement:
❑ Preelection Statement
Semi-annual Statement
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
COVER PAGE
Page of _
For Official Use Only
❑ Quarterly Statement
❑ Special Odd -Year Report
❑ Supplemental Preelection
Statement - Attach Form 495
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
Fax 760-564-1625
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 an rrect.
Executed on 7/1'a,
netureof reasurer orAssistant Treasurer
Executed on 4 J By !/
Date I Signature ofC rohna Officahnid- r:andirintw Rtata UP— —Prnnnnant nr Rwennncihla r)ffi—of Rnnnmr
Executed on
Date
B�
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/OS)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772)
State of California