HomeMy WebLinkAbout1994 Form 470 Officeholder and Candidate Type or print in Ink. SHORTFORM
Campaign Statement —Short Form
ry
(Government Code Section 84206) For Official Use Only
For use by officeholders and candidates who do not have a controlled committee and who do not anticipate
receiving $1,000 or more in contributions and do not anticipate spending $1,000 or more during the calendar year. Officeholders whose salary is less than $100 per month and judges who have a controlled
committee may use this form under certain circumstances. See the Information Manul Cam ai n Disclosure Provisions of the Political Reform Act for Elected Officeho ers Can I ales an T eIr Controlled
C ommittees or further information.
I Statement Covers Calendar Year 19 44_ .
II Officeholder or Candidate Information III Information on Office Sought or Held
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
RESIDENTIAL OR BUSINESS ADDRESS (NO. AND STREET) JURISDICTION (LOCATION) DISTRICT NUMBER
(IF APPLICABLE)
CITY STATE ZIP CODE DATE OF ELECTION (MONTH, DAY, YEAR) (IF APPLICABLE)
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AREA CODE /DAYTIME PHONE NUMBER
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IV 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 M
V_ 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.
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Executed on I I S At �P,.0 .Ie_ C7tl By
ATE CITY AND STATE N URE F OFf ICEHOLDER OR CANDIDATE
FOR INF ORM A I ION RE OUIRF D TO BE PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT Or 1977, SEE INFORMATION MANUAL ON CAMPAIGN DISCLOSURE PROVISIONS Or T H E POETICAL REFORM ACT
State of California Fair Political Practices Commission