HomeMy Public PortalAboutForm 470Officeholder and Candidate
Campaign Statement —
Short Form
Date of election if applicable:
(Month, Day, Year)
n/a
1. Statement Covers Calendar Year 20 21
2. Officeholder or Candidate Information
NAME OF OFFICEHOLDER OR CANDIDATE
Corey Calaycay
STREETADDRESS
207 Harvard Avenue
CITY STATE ZIP CODE
Claremont CA 91711
AREA CODE/DAYTIME PHONE NUMBER OPTIONAL: FAX/E-MAIL ADDRESS
(909)399-5441
❑ Amendment (Explain Below)
3. Office Sought or Held
OFFICE SOUGHT OR HELD
City Councilmember
OFro K
C�q�R R
�&IQNT
For Official Use Only
JUKIJUIU I IUN (LUUAI IUN) I UIb I KIU I NUMIJtK
(IF APPLICABLE)
City of Claremont 1
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
5. Verification
COMMITTEE ADDRESS
NAME OF TREASURER
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 $2,000 during the calendar year and that I have used
all reasonable diligence in preparing this statement. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on SID By
DATE
SIGNATURE OF
FPP or 4701470 Supp-pkghent (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov