Kennedy 470Officeholder and <;andidate
Campaign Statement -
Short Form
(Government Code Section 84206)
Type or print in ink.
Date of election if applicable: D Amendment (Explain Below)
(Month, Day, Year)
Date Stamp
1. Statement Covers Calendar Year 20 0 + .
STREET ADDRESS
CITY~
AREA CODE/DAYTIME PHONE NUMBER
S-to ~ 1lf f--l ff1_~
4. Committee Information
STATE ZIP CODE
04 t{t/J'D/
OPTIONAL: FAX I E-MAIL ADDRESS
3. Office Sought or Held
OFFICE SOUGHT OR HELD
DISTRICT NUMBER
(IF APPLICABLE)
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 LD. NUMBER COMMITTEE ADDRESS NAME OF TREASURER
1/\1 nf\e,,
5. Verification
1 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 duri~g th_e
calendar year and that I have used all reasonable diligence in preparing this statement. I certify nd pe alty of per ry under the laws of the State of Cahforrna
that the foregoing is tru~ :d :orrr ct. ~~~
Executed on L? -oe By __ _,. ;__-+,,,,;:;_-----+----;=.-------------
DATE
FPPC Form 470/470 Supplement (January/OS)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
Officeholder and Candidate
Campaign Statement -
Short Form
(Government Code Section 84206)
Type or print in ink.
Date of election if applicable: D Amendment (Explain Below)
(Month, Day, Year)
1. Statement Covers Calendar Year 20 _,. _!\: l '-j J
2. Officeholder or Candidate Information
STRE
CITY STATE ZIP CODE ,/ 'f-i CA qvj i)l/ ~\
AREA CODE/DAYTIME PHONE N~MBER Gt-v~J ~s ~ tg~b OPTIONAL: FAX/E-MAILADDRESS
4. Committee Information
!FA !CABLE) D:ST~T NUMBER
List all committees of which you have knowledge that are primarily formed to receive contributions or to make expenditures on behalf of your candidacy.
COMMITIEE NAME AND l.D. NUMBER COMMITIEE ADDRESS NAME OF TREASURER
5. Verification
I declare under penalty of perjury that to the best of my knowledge I anticipate that I will receive less than $1 00 and that I will spend less than ,000 during the
calendar year and that I have used all reasonable diligence in preparing this statement. alty of perjury under the laws e State of California
that the foregoing is ue a d correct. ~ · ........... -··
Executed on SIGNATURE OF OFFICEHOLDER OR CANDIDATE /
FPPC Form 470/470 Supplement (January/OB)
FPPC Toll-Free Helpline: 866/ASK·FPPC (866/275-3772)