HomeMy WebLinkAboutSCRIVNER PREELEC04(2) AMENDRecipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Date of election if applicable
(Month, Day, Year)
COVER PAGE
e 1 of 9
For Official Use Only
1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4.
[] Officeholder, Candidate Controlled Committee O State Candidate Election CommiEee
O Recall
[] General Purpose Committee O Sponsored
O Small Contributor Committee
O Political Party/Central Committee
[] BaLlot Measure Committee O Pdmadly Fora]ed
O Controlled
O Sponsored
[] Pdmadly Formed Candidate/
Officeholder Committee
3. Committee Information [,D NUtM2BTE0~n
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMM[TTE~)
ZACK SCRIVNER foz CITY COUNCIL
OPTIONAL FAX/E MA[LADDRESS
4. Verification
2. Type of Statement:
[] Preeie¢ion Statement [] Quarterly Statement
[] Semi-annual Statement [] Spedal Odd-Year Report
[] Termination Statement [] Supplemental Preelection
[~ Amendment (Explain below) Statement - AEach Form 495
Treasurer(s)
NAME OF TREASURER
ANDY STANLEY
MAILING ADDRESS
NAME OF ASSISTANTTREASURER IF ANY
MAILING ADDRESS
CITY STATE ZiP CODE AREA CODE/PHONE
OPTIONAL FAX/E MAIL ADDRESS
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the at~ached schedules is true and complete. I
cer(ify under penalty of perjuW under the laws of the State of California that the foregoing is true and correct.
Date
/a-;z-o,-(
By
www. netfile, corn State of Cllifornia