460 Henderson 2014 from 06/30 - 08/22recipient Commit
Campraign Statement
"Coves Page,
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period
from 6/30/14
through 8/22/14
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
❑ General Purpose Committee
(Also Complete Part 6)
Q Sponsored
❑ Primarily Formed Candidate/
Q Small Contributor Committee
Officeholder Committee
Q Political Party/Central Committee
(Also Complete Part 7)
3. Committee Information
I.D. NUMBER
1349748
NAME (OR CANDIDATE'S NAME IF NO
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
760-564-1625
OPTIONAL: FAX / E-MAIL ADDRESS
COVER PAGE
CITY CLERK'S �OFFIC
Date of election if applicabl�hh
Page of
(Month, Day, Year) U 4 SEP 19 AIq 10: 11 For Official Use Only
11/16/12 C TY OF LA QUANTA
CALIFORNIA
2. Type of Statement:
❑ Preelection Statement ❑ quarterly Statement
❑ Semi-annual Statement ❑ Special Odd -Year Report
EZ 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
OPTIONAL: FAX / E-MAIL ADDRESS
760-563-1625
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge
under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on 9 A f f I V By
Dat
Executed on By «�
ate Signature of Co IlhgOf
Executed on By y Signature
STATE ZIP CODE AREA CODE/PHONE
contained herein and in the attached schedules is true and complete. I certify
Executed on g
Date y Signature of ControllingOtficeholder,Candidate,StateMeasureProponent FPPC Form 460 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772)
State of California