Form 470Officeholder and Candidate Type or print In Ink. C 0`�F 917r?I7d5
Campaign Statement— v
CI7'1' LE_,
Short Form f
(Government Code Section 84206) Date of election if applicable: Amendment (Explain Below)
(Month, Day, Year) '�o' OCT _5 PH 4 I¢5
1. Statement Covers Calendar Year 20 Z
2. Officeholder or Candidate Information
C � - Cl <3,7. S
PHONE NUMBER
3. Office Sought or Held
OFFICE SOUGHT OR HELD
,
t.ov.
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 ID. NUMBER I COMMITTEE ADDRESS
NAME OF TREASURER
5. Verification
I declare under penalty of perjury that to the best of my knowledge I anticipate that I will receive less train $1,0(
calendar year and that I have used all reasonable diligence in preparing this statement. I certify and enalty
that the foregoing is true and correct.
Executed on 1 - ? 2-4— 1 Z By
DATE 51
d less than $1,000 during the
laws of the State of California
OR CANDIDATE
FPPC Form 4701470 Supplement (January/08)
FPPC Toll-Free Helpfine: 866 /ASK.FPPC (866/276.7772)