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Kearney 470I ~Officeholder and Candidate Campaign Statement - Short Form Type or printl1n Ink. I (Government Code Section 84206) Date of election If applicable: (Month, Day, Year) 1. Statement Covers Calendar Year 20 J2!/-. i : D Amendment (Exp1a1 i I LDED R 3 1 2005 OF ALAMEDA LEAK'S OFFICE 2. Officeholder or Candidate Information 3. Offi~e Sought or Held NAME OF OFFICEHOLDER OR CANDIDATE tGYlr/ OFFIC~1 ~UGHTORHEL~ ". kJlf Dt ~b,~ STREET ADDRESS I t <{'-{:: CA q '15'0 I\ JURIS~ICTION (LOCATION) OPTIONAL: FAX I E·MAIL ADDRESS AREA CODE/DAYTIME PHONE NUM~ /' go-'], t,q-'IJ' vu f::, SHORT FORM CALIFORNIA 470 FORM . For Official Use Only DISTRICT NUMBER (IF APPLICABLE) 4. Committee Information , List all committees of which you have knowledge that are primarily formed to r~eive contriqutions or to make expenditures on behalf of your candidacy. I I COMMITTEE NAME ANO l.D. NUMBER COl\1MITTEE ADDRESS NAME OF TREASURER I I 5. Verification ' I declare under penalty of perjury that to the best of my knowledge I anticipate1that I will receive less than $1,000 and that I will sp less than $1,000 during the calendar year and that I have used all reasonable diligence in preparing this statement. I certify un r penalty of perjury un the laws of the State of California that the foregoing is true and correct. / 1 h Executed on M ,,A~ j D l ~t;;;Db I BY-------- FPPC Form 450 (June/01) FPPC Toll-Free Helpline: 866/ASK-f PPC · Officeholder and Candidate ·Campaign Statement · Form 470 Supplement (Government Code Section 84206) SEE INSTRUCTIONS ON REVERSE ! Type or print inl Ink. 0 4mendment :(Explain Below) This form is written notification that the officeholder/candidate listed below has re9eived contributions totaling $1,000 or more or has made expenditures of $1,000 or more during the calendar ~ear. 1. Officeholder or Candidate Information NAllllE OF OFFICEHOLDER OR CANDIDATE STREET ADDRESS CITY AREA CODE/DAYTIME PHONE NUMBER 2. Office Sought OFFICE SOUGHT DATE OF ELECTION (MONTH, DAY, YEAR) ' STATE OPTIONP,L: FAX/E-MAILtDDRESS DISTRICT NUMBER (IF APPLICABLE) FORM 470 SUPPLEMENT Date Stamp CALIFORNIA 470 FORM SUPPLEMENT For Official Use Only 3. Date Contributions Totaling $1,000 or More Were Received or Date Expenditures of $1,000 or More Were Made (MONTH, DAY, YEAR) FPPC Form 450 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC