2020-06-22 Form 410 - MiddletonCEIV
CITY OFEPALM SGPRINrac
2020 JUN 22 wi
)IFFICE OF THE CITY
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S,tatementType
❑Initial
® Amendment
❑ Termination -se t(S,
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I.D. Number t
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2. TreasurerOther Principal Officers
NAME Of COMMITTEE
Lisa Middleton for City Council, District 5, 2020
DAME O[ TREASURER
Kathy Weremiuk
STREET AODRESSINO RO, BDQ
699
ADDRESS NO PO 8=1
CITY
SUITE
ZIFCOOE
AREACODUPHONE
840
Springs
CA
92262
310-
STATE ZIP CODE AREA
Friedes
FULL MAILING ADDRESS (IF DIFFERfNTI
STREET
MAI I. ADDRESS IREOUIREq/FAR IOPTIONALI
CITY
STATE
ZIPCODE
AREA COOF/PHONC
Iisamiddletonps@icioud.
Springs
CA
92264
206-
OF DOMICIIF
IVRISgR10N WNERe COMM MrEE n AITVE
NAME OF PA NCIML OFFICERS]
Riverside
Palm Springs
Lisa Middleton
STREET ADDRESS END Ro. BOX)
840
STATE
ZIPCOOE
ARG CODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
3. Verification
Palm Springs
CA
92264
760-
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penalty of perjury under the laws of the E
Executed on 06101/2020 __. BV
EXecuted on 06/01 /2020 By
DATE
Executed on 0610111 By
DATE
Executed on By
WEE SO14ATURE OF CONTROLLING OFFICINOU ER CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410(Augmt/2018)
FPPCAdvice: advioe®fnoc.ca.aov (866/275-3772)
www.fpoc.ca.eov
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