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Kennedy 470Officeholder and Candidate Campai Statement ShortForm (Government Code Section 84206 T or print in ink. Date of election if applicable; (Month, Da Year El Amendment (Explain B Date Stamp 04 JUL 01 T Y OF A LA 44-Voil' SHORT FORM For Official Use Onl 1. Statement Covers Calendar Year 20 2. Officeholder or Candidate Information 3. Office Sou or Held NAME OF FFICEHOLDOIF? R CANDIDATP OFFICE SOUGHT OR HELD oxv STREET ADDRESS //1 wes JURISDICTION (L CATION) DISTRICT NUMBER C (IFAPPLICABLE) 5. Verification I declare under penalt of .perjur that to the best of m y knovAed I anticipate that I will receive I calendar y ear and that I have used all reasonable dili in preparin this statement, I certi that the fore is true an correct Executed on B AT E than $1 000 and th 0 ill spend less than $1,000 durin the rer pe4lt offier- r der the laws of the State of California SIGNATURE Of OFFICEPTCEDER OR CANDIDATE I FPPC Form 4701470 Supplement (Januar FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772)