HomeMy WebLinkAboutForm 470 Bourbeau 063021Officeholder and Candidate
Campaign Statement —
Short Form
1. Statement Covers Calendar Year 20 3 1
Date of election if applicable:I ElAmendment (Explain Below)
(Month, Day, Year)
2. Officeholder or Candidate Information 3.
NAME OF OFFICEHOLDER OR CANDIDATE
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AREA CODE/DAYTIME PHONE NUM
OPTIONAL: FAX/E-MAIL ADDRESS
Date Stamp
RECEIVED
JUL i ol 2021
CITY OF ATASCADERO
CITY CLERK'S OFFICE
Office Sought or Held
OFFICE SOUGHT OR HELD
JURISDIC N (LOCATIONI DISTRICT NUMBER
/ 'r,/ -; [IFAPPLICABLE)
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
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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.
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FPPC Form 470/470 Supplement (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov