HomeMy WebLinkAboutBENHAM SUSAN MERRILL 502 ampaign Bank Account
Type or Print In ink.
Check One:
[~nifial
[] Amendment
[] Redesignate the Account for Fu(ure
Election to the Same Office
1. Candidate information
FULL NAME OF CANDIDATE (LAST, FIRST~ MIDDLE}
CAMPAIGN BANK ACCOUNT
For Olfk:lal Use On~y
DAYTIME PHONE E-MAIL (OP rlONAL) --
CUY STA~E ZiP C~E FAX NUMBER
OFFICE SOUGHT AND AGENCY NAME
/
2. Account Information
DAYTIME PHONE
CRY STATE ZiP
3. Verification
ACCOUNT NUMBER
DATE OPENED (Mof~th/Day/Year)
I certify under penally of perjui'y under the laws of the State of California that the foregoing is true and correct.
FPPC Fo~m 502 (8/99)
For Technical Asslslance: 916/'322-5660