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Kennedy 470Officeholder and Candidate Campaign Statement — Short Form (Government Code Section 84206) Type or print In ink. Date of election if applicable: 0 Amendment (Explain Belo (Month, Day, Year) 1. Statement Covers Calendar Year 20 2. Officeholder or Candidate Information NAME OF OFFICEHOLDER OR CA DIDATE I I 1 (A) L (il 60/1 I STREET ADDRESS CITY AREA CODE/DAYTIME PHONE NUMBER tHir 4. Committee Information STATE 18■■■■■■■■■111 ZIP C ) DE Tat.ceistarE3— FES 3 20i§ SHORT FORM 4.-Al.fFoRNIA 470 ' FORM CITY OF ALAMEDA CITY CLERK'S OFFICE OPTIONAL: FAX! E-MAIL ADDRESS- 3. Office Sought or Held OFFICE SOUGHT OR HELD r-7— JURISDICTION (LOCATION) (1,( For Official Use Only 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 I.D. NUMBER 1 COMMITTEE ADDRESS NAME OF TREASURER tA- 5. Verification I declare under penalty of perjury that to the best of my knowledge I anticipate that I will receive less AlOn 1,000 and that will spend less than $1,000 during the calendar year and that I have used all reasonable diligence in preparing this statement. I laws of the State of Califomia that the foregoing is true and correct. Executed on 1 DATE By SIGNATURE 0 OFFICEHOLDER OR CANDIDATE FPPC Form 470/470 Supplement (January/08) FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772)