HomeMy WebLinkAboutForm 470 Bret Heinemann 092420ficeholder and Candidate
mpaign Statement —
ort Form
Date of election if applicable:
(Month, Day, Year)
Statement Covers Calendar Year 20 -94,iL 19
El Amendment Explain Beiow)
Officeholder or Candidate Information 3. Office Sought or Held
NAME OF OFFICEHOLDER 0R41,1& �r� �/ OFFICE SOUGHT OR HELD
STREETADDRESS
c! fiN -y
a TY
i E-MAIL
(LOCATION)
Date Stamp
RECEIVED
5tt` 2 4 2020
CITY OF ATASCADER
CITY CLERK'S O;=FIC
For Official Use
C� I ff APPLrCABLE)
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 COMMITTEE ADDRESS NAME OF TREASURER
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.
r
Executed on — y - By
DATE SIGN A7 0€FICEHDLDER 0R CANDIDATE
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FPPC Form 4701470 Supplement (Jan/201f))
FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov