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Kennedy 470Officeholder and Candidate Campai Statement — Short Form ( G overnment Code S ection 84206 T or print in ink. Date of election if applicable: ❑ Amendment (Explain Below (Month, Da Year) 1. Statement Covers Calendar Year 2® �C R mael z W a Q V IT, For Official Use Onl Officeholder or Candidate Informatior, ----------- ---------- - 4 ", 4 3. Office Sou or Heb",J OFFICE SOUGHT OR HELD JURISDICTI, N (COCA ION) DISTRICT NUMBER (IF APPLICABLE) AREA CODE/DAYTIME PHONE NUMBER . .... . .... ......... ................. .. . ......................... . . .... .......... . . - -------------- - OPTIONAL: FAX/ E-MAIL ADDRESS 4. Committee Information List all committees of which y ou have knowled that are primaril formed to receive contributions or to make expenditures on behalf of y our candidac COMMITTEE NAME AND I.D, NUMBER I COMMITTEE ADDRESS I NAME OF TREASURER P 0 osie_� ... .... ... ....... ... ... . .... 5. Verification I declare under penalt of perjur that to the best of m knowled I anticipate that I will receive less than $1 , 000 and that I will spend less than $1 , 000 durin the calendar y ear and that I have used all reasonable dili in preparin this statement. I certif under p Malt of perjur under the laws of the State of California - . '7= that the fore is trup and correct. Executed on B I DATE SIGNATU OF OFF] CE H OLDE R OR CANDIDATE FPPC Form 470/47❑ Supplement (Januar FPPC Toll-Free Helpline: 8661ASK-FPPC (8661275-3772)