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HomeMy Public PortalAboutForm 470Officeholder and Candidate Campaign Statement — Short Form Date of election if applicable: I ❑ Amendment (Explain Below) (Month, Day, Year) 11/8/2022 1. Statement Covers Calendar Year 20 20 2. Officeholder or Candidate Information 3. Office Sought or Held NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD Jennifer Stark for Claremont City Council 2022 STREETADDRESS 242 Eagle Grove Avenue STATE ZIP CODE Claremont CA 91711 AREA CODE/DAYTIME PHONE NUMBER OPTIONAL: FAX/E-MAIL ADDRESS 909-913-2580 jenniferstarkis@gmail.com For Oficial Use Only J U L 2 9 2020 CITY CLERK City Councilmember JURISDICTION (LOCATION) DISTRICT NUMBER (IF APPLICABLE) City of Claremont 3 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 I.D. NUMBER COMMITTEE ADDRESS Jennifer Stark for Claremont City Council 2022, ID 1424487 1242 Eagle Grove Avenue, Claremont, CA 91711 I Simon Brown 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 all reasonable diligence in preparing this statement. I certify under penalty of perjury under the laws of the St to of California tVfthe foregoin Executed on �/;2 L�V; V y NAME OF TREASURER during the calendar year and that I have used and correct. DATE SIGt)I TURE OF OFFICEHOLDER OR CANDIDATE FPPC Form 470/470 Supplement (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov