HomeMy WebLinkAboutTAKII SARA 502 ampaign Bank Account
Check One: ,~lnilial
[] Amendment
Type or Print in Ink.
[] Redesignate the Account for Future
Election to the Same Office
Date Stamp
O0 AUG I 8 PH 2:26
~jAKE,RSF~:Li~, CFf Y
Candidate Information
FULL NAME OF CANDIDATE (LAST, ~:IRST, MIDDLE)
/ r'- ,L-) ,,_) hi
ADDRESS (NO. AND STREET)
CFTY
OFFICE SOUGHT AND AGENCY NAME
2. Account Information
STATE ZIP CODE
DAYTIME PHONE
FAX NUMBER
ADDRESS ~__~ STREET
CITY
CAMPAIGN BANK ACCOUNT
CALIFORNIA
FoRM 502
3. Verification
For Official Use Only
E-MAIL (OPTIONAL)
TYPE OF ELECTION [] Special [] Recall
(Check One If Applicable)
YEAR OF ELECTION
2oob
DAYTIME PHONE
ACCOUNTNUMBER
DATE OPENED(Monlh/Oayffear)
I cedify under penalty of perjuly under the laws of the State of California that the foregoing is a d corm
, Ilorrtla IRa[ IRe tOr/g~~TE
DATE
FPPC Form 502 (8~99)
For Technical Assistance: 916/322-5660