HomeMy Public PortalAboutForm 470 (2)
Officeholder and Candidate
Campaign Statement -
Short Form
(Government Code Section 84206)
SHORT FORM
Type or print in ink.
Date Stamp
CALIFORNIA 470
FORM
Date of election if applicable:
(Month, Day, Year)
0 Amendment (Explain Below)
For Official Use Only
1. Statement Covers Calendar Year 20 t9 5-
2. Officeholder or Candidate Information
NAME OF OFFICEH, O_LDE,R OR CANDIDA!E , , ¡> --
/lIl vC,-. ~ .7rcA ("7 cJ ~ ~ê41'd-z1
STREET ADDRESS
~<;~
3. Office Sought or Held
-,' OFFICE SOUGHT,OR HELD, ..'-~ ^ /\ , "'- ..
~-I-!I c:.e Lø-vn c{ (
_.- JURISDICTION (LOCATION)
é' (~?'V~ CYvZ +.
ÌM e VPt (4.~ c,.,-
s.s 6 (}¡v ~ 'T ( d-fi1
CITY - STATE ZIP CODE -
d 7V &-wt øV t-- (è r' J - ~ '-1 D Þ1 .e tJ;., I /1 (J-¡J. C ÙV?
AREA CODE/DAYTIME PHONE NUMBER OPTIONAL: FAX / E-MAIL ADDRE&l r.7'"" ..
DISTRICT NUMBER
(IF APPLICABLE)
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 /.0. NUMBER COMMITTEE ADDRESS NAME OF TREASURER
5. Verification ,./
/'
I d~clare und, ,e, r~lty of perjury that to the be"st of my ,~nowled.ge I anti~iPa,te.th~ I Wil,l, re eive I~ss than $1,000 and that I Will, ~pend,less than $1,000 during
the calendarYé~~ ~d that I have used all re~~onable diligence I prepanngthls state me,. certIfy under penal of per ury n e laws of the State of
:x::~::z.at~g.Oi~9 i~ct. , - - '?ø7ò {/ ~ -. " ~ ~,
~-I~ DATE '\.. ~ ,,/51 OF 0 (I ,J,~DlDATE '--,
.--~ I / ,"",----, 1/"'"
.;~/ L/ ( FPPC Form 450 (JuneJ01)
/ ,FPPC Toll-Free Helpline: 866/ASK-FPPC
Officeholder and Candidate
Campaign Statement
Form 470 Supplement
(Government Code Section 84206)
Type or print in ink.
FORM 470 SUPPLEMENT
0 Amendment (Explain Below)
Date Stamp
CALIFORNIA 470
FORM SUPPLEMENT
For Official Use Only
SEE INSTRUCTIONS ON REVERSE
This form is written notification that the officeholder/candidate listed below has received contributions totaling
$1,000 or more or has made expenditures of $1,000 or more during the calendar year.
1. Officeholder or Candidate Information
NAME Oj9?FI~EHOLDER..OR CANDIDATE ~
/ Ul l ¿ ??Õ- e-/ (
CITY
5~ 6 wpc;'t-
C( ð v~ hA ávi/
Jvf¡v-;
I () '17/1
(('" C€ C/1 '") VJ
:;1-v-.e~(
STREET ADDRESS
AREA CODE/DAYTIME PHONE NUMBER
STATE ZIP CODE
t -.
/7 '
c;;;) ~.,~ ðvh(r~
OPTIONAL: FAX / E-MAIL ADDRESS
2. Office Sought
Coon et-' I
f)M e/J/Vf ~
DISTRICT NUMBER
(IF APPLICABLE)
OFFICE SOUGHT
DATE OF ELECTION (MONTH, DAY, ~~R) . ~ ~.õ7 5
3. Date Contributions;("otaling $1,000 or More Were Received or Date Expenditures of $1,000 or More Were Made
I?
0
D"
~D
'--
FPPC Form 450 (June/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC