HomeMy WebLinkAboutForm 470 - Mark GalperinOfficeholder and Candidate
Campaign Statement —
Short Form
Date of election if applicable:
(Month, Day, Year)
1. Statement Covers Calendar Year 20 '21
1� V u
[P
Date Stamp
1 AI;;; - � '�024
Amendment (Explain BeloiPj
OP' LERK'S OFFICE
Official Use Only
2. Officeholder or Candidate Information 3. Office Sought or Held
N�A�MnE OF OFFICEHO`LLDDER OR CANDIDATE OFFICE SOUGHT OR HELD i
STREETADDRESS JURISDICTION (LOCATION) DISTRICT; dt,+."diER
: `� C' i �- o S Q 6� R 2 � t e �
STATE ZIP CODE
�QtA CA 9'1-g
AREACODE/DAYTIME PHONE NUMBER OPTIONAL: FAX/ E-MAIL ADDRESS
�-
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. NUMBER
5. Verification
COMMITTEE ADDRESS
NAME OF TREASURER
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 u �� s 9, Z By
aDATE
FPPC Form 470/470 Supplement (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov