HomeMy WebLinkAboutTATUM 470 01/15/20Officeholder and Candidate
Campaign Statement -
Short Form
Date of election if applicable: I ❑ Amendment (Explain Below)
(Month. Day, Year)
1. Statement Covers Calendar Year 20 2-0 .
2. Officeholder or Candidate Information
NAME OF OFFICEHOLDEROR CANDIDATE
&re9rry� Ta/ `/-4t1''"f
CITY STATE ZIP CODE
(461) 97`ZI6S'
AREA CODE/DAYTIME PHONE NUMBER OPTIONAL: FAX/ E-MAILADDRESS
Date Stamp
OF BAKERSF!
JAN 15 2020
3. Office Sought or Held
OFFICE SOUGHT OR HELD
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JURISDICTION (LOCATION) I L" "r � i rvUmor r'
` (IF APPLICABLE)
C 1+41
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 NAME OF TREASURER
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 $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 �a» / BY
DATE SIGNATURE OF OFFICEHOLDER OR CANDIDATE
FPPC Form 470/470 Supplement (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov