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HomeMy WebLinkAboutForm 460_07/16/19 Recipient Committee Date Stamp COVER PAGE Campaign Statement CALIFORNIA 460 Covr Pge ")RM I f1.t g e1o6 Statement covers period Date of election if applicable: J U L 16 2 u 19 a January 1 2019 from (Month,Day,Year) For Office. Use Only July132019 August 2019CITY CLERK DEPT SEE INSTRUCTIONS ON REVERSE through g 1. Type of Recipient Committee: All Committees-Complete Parts 1,2,3,and 4. 2. Type of Statement: O Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 2 Preelection Statement ❑ Quarterly Statement O State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd-Year Report 0 Recall 0 Controlled ❑ Termination Statement (Also Complete Part 5) 0 Sponsored (Also file a Form 410 Termination) (Also Complete Part 6) ❑ General Purpose Committee ❑ Amendment(Explain below) O Sponsored ❑ Primarily Formed Candidate/ O Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D.NUMBER Treasurer(s) 1417408 COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Committee to Elect Shelley Kaplan to City Council District One 2019 Shelley Kaplan MAILING ADDRESS 67785 Foothill Rd STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE 67785 Foothill Rd Cathedral City CA 92234 617-842-1243 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY Cathedral City CA 92234 617-842-1243 MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge information contained herein and in the attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correc July 13, 2019 Executed on By Date S', ature• reasure .r' ant Tr urer Executed on July 13,2019 By , //_ _ Date Signature of Controlling Officeholder,Candid. ,•.e Mea-!re Pro nt�er gesponsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder,Candidate,State Measure Proponent Executed on By Date Signature of Controlling Officeholder,Candidate,State Measure Proponent FPPC Form 460(Jan/2016) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov NI Q Lu I- � 2 � L � \\ / 0- ) / ) E ) a_ } ` ^ I 3 � W CO \ § y § 2E \ % \$# ƒ < % 22 - >- § SO OE EC SS a $ E z = o § < @ § % E > m EO L. 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