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HomeMy WebLinkAboutForm 470 - Mary-Lynne Bernald 2016Officeholder and Candidate Campaign Statement - Short Form Date of election if applicable: (Month, Day, Year) 1. Statement Covers Calendar Year 20 2. Officeholder or Candidate Information 0 Amendment (Explao Bei,* Date Stamp HUTT JUL 1 8 2016 CALIFORNIA FORM 470 For Official Use OiiE;r NAME OF OFFICEHOLDER OR CA NIPADATE Mor -'J- Ljrve ber nalci STREET ADDRESS C arci*o STATE zpri °ODE CA- q5c)1-C AREA CODE/DAYTIME PHONE NUMBER OPTIONAL: FAX f Er MAIL ADDRESS Office Sought or Held OFFICE SOUGHT OR HELD C U nCA NA ent/ ber JURISDICTION (LOCATION} DISTRICT NUMBEI, OF APPLICABLE) 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 I.D. NLIMBEE COMMITTEE ADDRESS IN) A . 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. NAME OE -MEASURER Eixecruled on DATE Clear Form Print Form By DER OP II(E FPPC Form 470/470 Supplement (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov