HomeMy WebLinkAboutCAPORALI 470 1/14/20Officeholder and Candidate
Campaign Statement -
Short Form Date of election if applicable:
(Month, Day, Year)
7,' 3 )-)'o
Date Stamp
CITY OF BAKERS
Amendment (Explain Below)
JAN 14 2020
!TY CLERKOr=b CF_
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1.. Statement Covers Calendar Year 20 1' -
2. Officeholder or Candidate Information 3. Office Sought or Field
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
Y
For Official Use Only
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 I.D. NUMBER
o N .-121
0 N -e-
5.
e-
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.
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Executed on �� `S G� C / `�_� U
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DATE
Clear Form PHnt`Form.'
FPPC Form 470/470 Supplement (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov