HomeMy WebLinkAboutBLANTON 470 3/1/16Officeholder and Candidate
Campaign Statement -
Short Form pate dejection naPPlicaele:
(m.1h, NY. YRRr)
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1. Statement Covers Calendar Year 20 (SL
2. Officeholder or Candidate Information
17 Amendment iEWiUcsoo )
NAME Of OFFICEHOLDER OR CAROIWIC
STREEi]DIMESa ..
STATE ".0
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MEAC00El0AYr1L1E PHONE NUMBER
16 MAR -3 PM 4:
III IELD Cl I T I
3. Office Sought or Held
OFFICE FOUGHT OR HEIO
JURIsibErnoN oconcH)
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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.
AND I D. NUMBER
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5. 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 alifomia VW the fore oing is true and certect.
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PPPG Form 4101410 Supplement (Jan12016)
FPPO Advice: advice@fppnca.gov (861UW53112)
www.fppc.w.gov