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HomeMy WebLinkAboutHedrick - Form 470 - 2022-08-12_RedactedOfficeholder and Candidate Campaign Statement — Short Form Date of election if applicable: (Month, Day, Year) I1VoV 8,V22 1. Statement Covers Calendar Year 202 Date Stamp RECEIVE ❑ Amendment (Explain Below) I I A U G 12 2022 2. Officeholder or Candidate Information 3. Office Sought or Held N)L OF OFFICEHOLDER OR CANDIDATE f 1 k---) ) I RK 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 I COMMITTEE ADDRESS 5. Verification 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 Califomia that the foregoing is true and cnrrert_ Executed on Ak `L � T 11 : -1-0_2,2— DATE SIGNATURE OF OFFICEHOLDER OR CANDIDATE FPPC Form 4701470 Supplement (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Officeholder and Candidate Campaign Statement Form 470 Supplement SEE INSTRUCTIONS ON REVERSE ❑ Amendment (Explain Below) This form is written notification that the officeholder/candidate listed below has received contributions totaling $2,000 or more or has made expenditures of $2,000 or more during the calendar year. 1. Officeholder or Candidate Information j DO A/A L—P E, ) 1 F Pt? / C NAME OF OFFICEHOLDER OR CANDIDATE 3CP-S-S007W S#C kA M r VT0 Dom: STREETADDIRESS 11 J /� L L 0&� CITY STATE ZIP CODE 5-50 - 2 2g1 AREA CODEIDAYTIMEPHONENUMBER OPTIONAL: FAX/ E-MML ADDRESS 2. Office Sought Vr rlt. e.7VU14M1 D 5T KICI NUMBER M A TIV � C 1 TY OF S " L41s Oplsp,12 (IFAPPLICABLE) DAT�7(0 ECTION (MONTH. DAY, YEAR) 1_ r 2- 3. r� � 02 DateCFA-AonTotaling $2,000 or More Were Received or Date Expenditures of $2,000 or More Were Made A (MONTH, DAY, YEAR) Date Stamp For Official Use Only FPPC Form 470/470 Supplement (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov