470 Sylk 2024 ElectionOfficeholder and Candidate
Campaign Statement —
Short Form
Date of election if applicable:
(Month, Day, Year)
Alt 1/, Sc011r
El Amendment (Explain Below)
Date Stamp
RECEIVED
SEP 2 6 2024
CITY OF LA QUINTA
„^,IIY CLERK DEPARTMENT
CALIFORNIA 470
FORM
For Official Use Only
1. Statement Covers Calendar Year 20 ? 1/
2. Officeholder or Candidate Information 3. Office Sought or Held
NAME OF OFFICEHOLDER OR CANDIDATE
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STREET ADDRESS
CITY STATE ZIP CODE
LA &21/rtire 4 ;,',1d,_3
AREA CODE/DAYTIME PHONE NUMBER OPTIONAL: FAX / E-MAIL ADDRESS
OFFICE SOUGHT OR HELD
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JURISDICTION (LOCATION)
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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
DISTRICT AB /
(IF APPLICABLE
)
NAME OF TREASURER
/VA
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5. Verification
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.
Executed on
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By
GNATURE OF OFFICEH
ER 0 C 1d DATE
FPPC Form 470/470 Supplement (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov