470 Officeholder and Candidate Campaign StatementOfficeholder and Candidate
Campaign Statement -
Short Form
1. Statement Covers Calendar Year 20
Date of election if applicable:
(Month, Day. Year)
Praia
El Amendment (Expiain Beiow) to U1 JUL 1 1 20
2. Officeholder or Candidate Information 3. Office Sought or Held
NAME OF OFFICEHOLDER OR CANDIDATE
15/W F Y. Gds A�J e�7
STREETADDRESS
CITY STATE ZIP CODE
-
CITY
Use Only
OFFICE SOUGHT OR HELD
JUF=iCTI (LOCATION) DISTRICT NUMBER
(iFAPPLiCABLE)
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.
COMMITTEE NAME AND I.Q. NUMBER
5. Verification
COMMITTEE ADDRESS
NAME OF TREASURER
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
Clear Form Print Form
FPPC Form 4701470 Supplement (Jan/2016)
FPPC Advice: advice@fppc_ca.gov (8661275-3772)
www.fppc.ca.gov