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Daysog 470Officeholder 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 -(JL_ . 2. Officeholder or Candidate Information NAME OF OFFICEHOLDER OR CANDIDATE Tony Da.ysas STREET ADDRESS CITY AREA CODE/DAYTIME PHONE NUMBER (510) 864-7593 4. Committee Information STATE ZIP CODE G~ 94501 OPTIONAL: FAX I E-MAIL ADDRESS 3. Office Sought or Held OFFICE SOUGHT OR HELD Councilmernber JURISDICTION (LOCATION) City of Alarneda JUL .3 1 200t rk's Of 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 l.D. NUMBER COMMITTEE 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 ,ooo during the calendar year and that I have used all reasonable diligence in preparing this statement. I certify u er penalty of 8§ · !Y under the laws of the State of California that the foregoing is true and correct. / Executed on __ J_u_l-=y,_· _J_l...;.,_2 _0_J_l ____________ _ DATE -~ DATE FPPC Form 450 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC