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470 Johnson 2024 ElectionOfficeholder and Candidate Campaign Statement — Short Form Date of election if applicable: (Month, Day, Year) Alo il6 i BIZ 5 2 a2 `t 0 Amendment (Explain Below) C Date Stamp RECEIVED SEP 2 6 2024 CITY OF LA OUINTA ITY CLERK DEPARTMENT CALIFORNIA 470 FORM For Official Use Only 1. Statement Covers Calendar Year 20 Z 7 2. Officeholder or Candidate Information 3. Office Sought or Held NAME OF OFFICEHOLDER OR CANDIDATE STREET ADDRESS OFFICE SOUGHT OR HELD 0s6per/ ---0i4(-)sD eOU /L //t/f/7 JURISDICTION (LOCATION) CITY STATE ZIP CODE C4 l"Z�_7 AREA CODE/DAYTIME PHONE NUMBER , OPTIONAL: FAX / EMAIL ADDRESS ! 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 I.D. NUMBER COMMITTEE ADDRESS NAME OF TREASURER A) A- 40- 5. Verification 1 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 $2,000 during the calendar year and that I have used all reasonable diligen$e in preparing this statement. I certify under penalty of perjury under the laws of the State of Caiifo j/ at the foregoing e and correct. Executed on 211 DATE SIGNATURE OF OFFICEHOLDER OR CANDIDATE FPPC Form 470/470 Supplement (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov