HomeMy WebLinkAboutSULLIVAN SEMIANN04(1)
COVER PAGE
Date Stamp
Type or print in ink.
Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200~84216.5)
of
Page
,~
,-
if applicable:
Day, Year)
Date of election
(Month,
Statement covers period
JAN 01 2004
For Official Use Only
r
i
,
p
04
from
JUN 30 2004
through
SEE INSTRUCTIONS ON REVERSE
Quarterly Statement
Special Odd~Year Report
Supplemental Preelection
Statement - Attach Form 495
D
D
D
2. Type of Statement:
Preelection Statement
Semi-annual Statement
Termination Statement
Amendment (Explain below)
D
iii
CJ
D
and 4.
All Committees - Complete Parts
Ballot Measure Committee
o Primarily Formed
o Controlled
o Sponsored
(AlsoCompJetePart6)
3,
2,
D
Committee
Officeholder, Candidate Controlled Committee
o State Candidate Election Committee
o Recall
(Also Complete Part 5)
Recipient
Type of
iii
1
Primarily Formed Candidate!
Officeholder Committee
IAlso Complete Part 7)
D
o General Purpose Committee
o Sponsored
o Small Contributor Committee
o Political Party/Central Committee
Treasurer(s)
.0. NUMBER
950347
NO COMMITTEE)
Committee Information
(OR CANDIDATE'S NAME
JACQUIE SULLIVAN FOR CITY COUNCIL
IF
COMMITTEE NAME
3.
NAME OF TREASURER
MYRIAM RIVAS-LAGUARDIA
STREET OR PO BOX
MAILING ADDRESS
AND
NO
DIFFERENT)
AREA CODE/PHONE
ZIP CODE
STATE
CITY
AREA CODE/PHONE
ZIP CODE
STATE
CITY
E-MAIL ADDRESS
FAX
OPTIONAL
E-MAIL ADDRESS
FAX
OPTIONAL:
contained herein and in the attached schedules is true and complete.
,
the
4. Verification
reasonable diligence in preparing and reviewing this statement and 10
penalty of perjury under the laws of the State of California that the foregoing
Executed on
Executed on
By
By
AUG 2 2004
Date
AUG 2 2004
Dale
I have used al
certify undel
FPPC Form 460 (June/01)
FPPC Toll-Free Helpline: 866/ASK.FPPC
State of California
Candidate, Slate Measure Proponent
Candidale, Slate Measure Proponenl
Officeholder
SignalureofControlllogOfflceholder
'C9
Signature of Control'
By
By
Date
Date
Executed on
Executed on
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