470 Annual
Type or print in ink.
D Amendment (Explain Below)
Date of election if applicable:
(Month, Day, Year)
Officeholder and Candidate
Campaign Statement
Short Form
(Government Code Section 84206)
PERTINO CITY CUERK
Officeholder or Candidate Information
NAME OF OFFICEHOLDER OR CANDIDATE
Dolores Sandoval
STREET ADDRESS
10720 Alderbrook Lane
CITY
Cupertino
AREACODEJDAYTIME PHONE NUMBER
DISTRICT NUMBER
(IF APPLICABLE)
Held
or
OFFICE SOUGHT OR HELD
Councilmember
JURISDICTION (LOCATION)
City of Cupertino
Office Sought
3
05
Covers Calendar Year 20
Statement
1
2
STATE ZIP CODE
CA 95014
OPTIONAL: FAX I E-MAil ADDRESS
408/725-8939
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 1.0. NUMBER COMMITTEE ADDRESS NAME OF TREASURER
Verification
I declare under penalty of perjury that to the best of my knowledge I anticipate that I will receive less than $1,000 and that I will spend less than $1,000 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 California
that the foregoing is true and correct.
5.
July 30, 2005
DATE
SIGNATURE OF OFFICEHOLDER OR CANDIDATE
FPPC Form 470/470 Supplement (January/OS)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
By
Executed on