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470 Sylk 2020 Election 09-23-20Officeholder and Candidate Campaign Statement — Short Form Date of election If applicable: (Month, Day, Year) 1. Statement Covers Calendar Year 20ALL . 2. Officeholder or Candidate Information RECEIVED SEP 232020 CITY OF LA QUINTA CIN CLERK DEPARTMENT Date SWnp a . . I. 1] Amendment (E.plainBak.) 3. Office Sought or Held RAM OF OFFCMIXAP �`�►`•'� � � / OFFICE S011GHr QR XE4� a TARO JUR1S01CTQN(WcATMN) DISTRICT NOMER ! — AREA CODEIDAYTME PHONE Ri1M13ER ❑PTIaltAL: FAX E-MAIL AMR --F,5 Por DNrt1a1 Use 4. Committee Information List all committees of which you have knowledge that are primadty formed to receive contributions or to make expenditures on behalf of your candidacy. COMWITEE NAME AND ID. NUMBER /1 1A - COMMITTEE ADDRESS NAME OF TREASURER 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 Gafdomia that the foregoing is true and correct. r a� Fxealed on r � BY CATS 3K�1ATIa�oF OF:ILFIrt?LCER IXi W1F! FPPC Form 4701470 Supplement (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661276-3772) www.fppc.ca.gov Officeholder and Candidate Campaign Statement Form 470 Supplement SEE INSTRUCTIONS ON REVERSE ❑ Amendment (Exo un Below) This form is written nolfication that the officeholder/candidate listed below has received contributions totaling $2,000 or more or has made expenditures of $2,000 or more during the calendar year. 1. Officeholder or Candidate Information a - HANE Of OFFICEHOLABR OR CANDIDATE STREL7A9O e,14 CITY 51ATC ap CODE NUMBER MIUYAL 2. Office Sought OFFICE BOUGHT DISTRICT NUMBER InAy (IF APPLICABLE) DATE OF ELECTION MONTH. DAY, YEAR) 3. Date Contrib///9-- ns Totaling $2,000 or More Were Received or Date Expenditures of $2,000 or More Were Made (MONTH, DAY, `IAJ Fn OffdW Use OAIy FPPC Form 4701470 Supplement (Jan/2076) FPPC Advice: advice@fppc.ca.gov (666/2763772) www.fppc.ca.gov