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470 Gray 2022 ElectionOfficeholder and Candidate Campaign Statement — Short Form Date of election If applicable: (Month, Day, Year) November 08,2022 ❑ Amendment (Explain Below) SEP 282022 CITY OF LA OUINTA CITY CLERK DEPARTME' CALIFORNIA 470 FORM I For Offidal Use Only 1. Statement Covers Calendar Year 20 22 2. Officeholder or Candidate Information NAME OF OFFICEHOLDER OR CANDIDATE Richard N Gray STREET ADDRESS CITY La Quinta STATE ZIP CODE CA 9225S AREACODEIDAYTIME PHONE NUMBER ( OPTIONAL: FAX I E-MAIL ADDRESS 3. Office Sought or Held OFFICE SOUGHT OR HELD La Quinta City Councilmember JURISDICTION (LOCATION) La Quanta City DISTRICT NUMBER (IF APPLICABLE) 4. Committee Information List all committees of which you have knowledge that are primarily formed to receive contributions or to make expenditures on behalf of your candidacy. COMMITTEE NAME AND W. NUMBER COMMITTEE ADDRESS NAME OF TREASURER N/A 5. Verification I declare under penalty of perjury that to the best of my knowledge I anticipate that I will receive less than $2,000 and that I will spend less than $2,000 during the calendar year and that I have used all reasonable diligence in preparing this statement. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. SIGNATURE OF DFFICE-tO ATE FPPC Form 470/470 Supplement (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov