HomeMy WebLinkAboutForm 470 - Maika Llorens GulatiCampaign Statement —
Short Form
Date of election If applicable: Amendment (Exp
Nain
(Month, Day, Year)
1. Statement Covers Calendar Year 20 25
2. Officeholder or Candidate Information 3. Office Sought or Held
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
Maika Llorens Gulati
STREETADDRESS
CITY STATE ZIP CODE
San Rafael CA 94901
AREA CODEIDAYTIME PHONE NUMBER OPTIONAL: FAX I E-MAIL ADDRESS
Councilmember
City of San Rafael
- t :� 8 2'125
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
PROINLI
VE�1201011.1
(IF APPLICABLE)
I
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 thattWmping is true and coned.
Executed on July 31, 2025
DATE
Z-
SIGNATURE
Form 4701470 Supplement (Jani2016)
FPPC Advice: advlce@fppe.ca.gov (8661275-3772)
www.fppc.ca.gov