HomeMy WebLinkAboutHUDSON 470 01/23/20Officeholder and Candidate Date Stamp CALIFORNIA
Campaign Statement -EE!! • - �
Short Form Date of election if applicable: CITY OF BAKER` — — For Official Use Onlv
(Month, Day, Year) Amendment (Explain Below)
JAN 23 2020
CITY CLERKS CFF ICI~
1. Statement Covers Calendar Year 20 Z
2. Officeholder or Candidate Information 3. Office Sought or Held
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
STREETADDRESS JURISDICTION (LOCATION)
11 (IF APPLICABLE)
CITY STATE ZIP CODE
AREA CODE/DAYTIME PHONE NUMBER OPTIONAL: FAX/ E-MAIL ADDRESS
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
v
S. 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 '� Z -c5 Z C- By ) -7`--7
DATE
Clearform Print Form
OF OFFICEHOLDER OR CANDIDATE
FPPC Form 470/470 Supplement (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov