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)