Kevin Kennedy 470Officeholder and Candidate
Campaign Statement -
Short Form
(Government Code Section 84206)
Type or print In Ink.
Dateofelectlon If applicable: D Amendment (Explain Below)
(Month, Day, Year)
Date Stamp
For Official Use Only
I erk' s Office
1. Statement Covers Calendar Year 20 ..D.L.
2. Officeholder or Candidate Information
STATE ZIP CODE
CA ~C/S-of
4. Committee Information
3. Office Sought or Held
OFFICE SOUGHT OR HELD
~ V'evS u,/'e,Y,....
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 1.0. 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 $1,000 during
the calendar year and that I have used all reasonable 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 {,/u/s l
1 1 DATE
Form 470/470 Supplement (12199)
For Technical Assistance: 916/322-5660
State of California