HomeMy WebLinkAboutBernald 2017 - 470Officeholder and Candidate
Campaign Statement -
Short Form
Date of election if applicable:
(Month, Day, Year)
1. Statement Covers Calendar Year 20
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0 Amendment (Explain Below)
Date Stamp
RECE V
31
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,1TY OF SARATOGA
For Official Use Only
2. Officeholder or Candidate Information
NAME OF OFFICEHOLDER OR CANDIDATE
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STREET ADDRESS
STATE ZIP CODE
Soxoto9o, q.5o1'O
AREA CODE/DAYTIME PHONE NUM
4. Committee Information
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 . NUMBER COMMITTEE ADDRESS NAME OF TREASURER
3. Office Sought o
OFFICE SOUGHT OR HELD 1 Pv,r�
JURISDICTION Coot \ C o u y c� y 1 \� �DISTRICT MBER
1-c: F 5oir(bto,,
Held
(IF APPLICABLE)
NIP
5. Verification
I declare under penalty of perjury that to the best of my knowledge I anticipate that I will receive less than $2 ,000 and that I will spend less than $2,000 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
Clear Form
Jaanu 9. 4 a a
DATE
Print Form
SIGNATURE OF OFFICEHOLDER OR CANDIDATE
FPPC Form 470/470 Supplement (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov