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470 TAYLOR 21-0630_RedactedOfficeholder and Candidate Campaign Statement — Short Form Dateof xlRn it applicattk: ❑ Amendment numan BFlwit (MBnM. Da µ 4ear) 2021 JUL 0 Ph 3: 14 11/6/2018 t. Statement Covers Calendar Year 20 21 CLERK( CAPISTRANO 2. Officeholder or Candidate Information 3. Office Sought or Held NAME or OFFICEHOLDER OR CANDIDATE OFFICE 8WGM OR HELD John S. Taylor City Council Member STREETADDRESS JURISINCTmx 6ocADONl DISTRICT NUMBER RFAPPIICABLEI City of San Juan Capistrano District CRY STATE DECODE San Juan Capistrano CA 92675 AREA COOESAttIME PHONE NUMBER OPTIONAL. FAXIEWALADDRFSS 4. Committee Information List all committees of which you have knowledge that are primarily fonned to receive wnbibutions or to make expenditures on behalf of your candidacy. COMMITTEE NAME AND in NUMBER I C09MTTEE ADDRESS I Mi OF TREASURER 5. Vedfication I declare under penalty of perjury that to the best of my knowledge I anticipate that I will receive less than I all reasonable dilige ce in prep 'ng this statement. I Denify under penalty of perjury under the laws of the EXecutedon �© ?v 2 By— DATE Cindy Russell that I have used — upplement(JaN2016) Advice: advlcoMppo.ca.gov, (8661215-3772) www.fppc.ca.gov