HomeMy WebLinkAboutForm 470- Linda Jackson 2015Officeholder and Candidate
Campaign Statement -
Short Form
Date of election if applicable:
(Month, Day, Year)
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1. Statement Covers Calendar Year 20 _/!5 . City of Sari KaTael
2. Officeholder or Candidate Information 3. Office Sought or Held
NAME OF OFFICEHOLDER OR CANDIDATE
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STREETADDRESS
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CITY STATE ZIP CODE
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AREA CODEIDAYTIME PHONE NUMBER OPTIONAL FAX E-MAIL ADDRESS
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4. Committee Information
OFFICE SOUGHT OR HELD
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JURISDICTION ;'OCAT111 DISTRICT NUMBER
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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 NUMBER
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S. Verification
COMMITTEE ADDRESS
NAME OF :REASURER
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.
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DATE • SIGNATURE OF OFFICEHOLDEROR DIDATE
FPPC arm 470/470 Supplement (Jan/2008)
FPPC Form 470/470 Supplement Instructions - Rev. 2 (Dec/2012)
Clear Form Print Form FPPC Advice: advice@)fppc.ca.gov (866/275-3772)
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