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HomeMy WebLinkAbout2001 Form 470 Officeholder and Candidate SHORT FORM Campaign Statement Type or print In ink. Dale Stamp 7F o r Short Form RE CEIVED (Government Cade Section 84206) Date of election if applicable: El Amendment (Explain Below) se Only (Month, Day, Year) JUL 31 2001 CITY CLERKS DEPT. 1. Statement Covers Calendar Year 20 . 2. Officeholder or Candidate Information 3. Office Sought or Held NAME OF OFFICEHOLDER RO O - R O CANDIDATE OFFICE SOUGHT OR HELD STREET ADDRESS JURISDICTION (LOCATION) DISTRICT NUMBER O (IFAPPLICABLE) CITY STATE ZIP CODE �Al' 'kito t C.1, C Pf 1 \1 - 'nt 1 AREA CODE/DAYTIME PHONE NUMBER OPTIONAL: FAX /E- MAILADDRESS 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.D. NUMBER COMMITTEE ADDRESS NAME OF TREASURER 5. Verification 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. Executed on �I 3 `( 9 � By DATE SIGNATUkJbF OFFICEHOLDER OR CANDIDATE FPPC Form 450 (June /01) FPPC Toll -Free Helpline: 866 /ASK -FPPC