HomeMy WebLinkAboutBernald -Form 470Officeholder and Candidate
Campaign Statement -
Short Form Date of election if applicable: El Amendment (Explain Below)
(Month, Day, Year)
1 Statement Covers Calendar Year 20
RECEIVED7FGr
ITY OF SARATOG
2. Officeholder or Candidate Information
3. Office Sought Held
OFFICE SOUGHT OR HELD
NAME OF OFFICEHOLDER OR CANDIDATE I
Mo r!S1 ��� ��P P C3�r G 1� DISTRICT NUMBER
JURISPICTION (LOCATION) (IF APPLICABLE)
STREET ADDRE � t
CITY STATE ZIP CODE
6aa CA 0115 0 0
AREA CODEIDAYTIME PHON MBER OPTIONAL. FAXIEMAILADDRESS
� ran ► l ern(2l SQ Lakq? C-a . u s
4. Committee Information
List all committees of which you have knowledge that are primarily formed to receive contributions or to make expenditures on behalf ofNAME
o OFTREASURER
COMMITTEE NAME AND I.D. NUMBER
COMMITTEE ADDRESS
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 have
used all reasonable diligence in preparing this statement. I certify under penalty of perjury under the laws of the Stale of California that the foregoing is true and correct.
Executed on O � O y SIGNATURE OF OFFICEHOLDER OR CANDIDATE
DATE
Clear Form Print Form FPPC Form 470/470 Supplement (Janl2016)
FPPC Advice: advice@fppc.ca.gov (866/275.3772)
www.fppc.ca.gov