Michael McMahon 470Type or print in ink. Date Stamp
Officeholder and Candidate
Campaign Statement -
Short Form r--------r------~""H ~ fui~ f~
Date 1>f election if applicable: D Amendment (Explain Bel W'" '\..., '' ' l "'...i ' (Government Code Section 84206) (Month, Day, Year) \ ,' ' Al
1. Statement Covers Calendar Year 20 _Q,3_ •
2. Officeholder or Candidate Information
NAME OF OFFICEHOLDER OR CANDIDATE
STREET ADDRESS
CITY STATE ZIP CODE
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AREA CODE/DAYTIME PHONE NUMBEfl' OPTIONAL: FAX/ E-MAIL ADDRESS
Cs, o) 72-7 -31 t.-12
4. Committee Information
3. Office Sought or Held
OFFICE SOUGHT OR HELD
SC1 0 01-f3 0 ltR.l(J
JURISDICTION (LOCATION)
r9 <..-/-} «J£ J9
DISTRICT NUMBER
(IF APPLICABLE)
List all committees of which you have knowledge thai' are primarily formed to receive contributions or to make expenditures on behalf of your candidacy.
COMMIITEE NAME AND LO, NUMBER COMMIITEE 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 $1,000 and that I will spend less than $1,000 during
the calendar year and that I have used all reasonablEi diligence in preparing this statement. I certify under penalty of perjury under the laws of the State of
California that the foregoing is true and correct.
Executed on ______ .,,.~------~---"'"'--:::r~--",;2.-_l. __ ....,. __ :L-_O_o__,_$1_ ~ / CANDIDATE
FPPC Form 450 (June/01)
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