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470 Johnson 2022 ElectionOfficeholder and Candidate Campaign Statement — Short Form Date of election M applicable: (Mmth, Day, Yeer) Amendment (E,pleie Below) 'RECEIVED Q SEP 2 8 "UZ/ ITY OF LA ❑UINTA CALIFORNIA FORM ' Tor Der I. iY. 7. Statement Covers Calendar Year 20 G • 7/l/ - _ g %c./4 CITY CLERK DEPARTMENT 2. Officeholder or Candidate Information 3. Office Sought or Held NAME OF OFRCEHOLDet OR CANDIDATE STREci ADDRESS LIT STATE UP CODE O ii,J>A 9zzs<3 AREA CODE/DAYTIME PHONE NUMBER OPTIONAL_ FAX/ E•MAILADDRESS , OFFICE SOUGHT OR HELD Co✓'C/L'i4 A 1URLSD(C11ON ILOCArrCt 6rr etc 44 06,,W74 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 I.D. NUMBER DISTRICT NUMBER ! (IF APPLICABLE) , 4 COMMITTEE ADDRESS NAME OF TREASURER 414 5. Verification I declare under penalty of perjury that to the best of my knowledge I anticipate that I will receive less Mon $2,000 and that I will spend all reasonable diligence in preparing this statement. I certify under penalty of perjury under the laws of the State of California Executed an /2 7/2a- DATE than 12,000 during the calendar year and that I have us�1 oregoing is - and FPPC Form 470/470 Supplement (Jan/2016) FPPC Advice: advicerpfppcca.gov (866/275-3772} www.fppc.c. { r