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  • VanPeborgh - 9.9.18

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    The Union
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    1. This document is a campaign finance disclosure form for a candidate or officeholder for calendar year 20XX. 2. It provides information about the candidate such as their name, office sought, and contact information. 3. The candidate certifies under penalty of perjury that they anticipate receiving less than $2,000 and spending less than $7,000 for the calendar year and that the form is true and correct to the best of their knowledge.

    Original Description:

    Campaign filing for Peter Van Peborgh

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    1. This document is a campaign finance disclosure form for a candidate or officeholder for calendar year 20XX. 2. It provides information about the candidate such as their name, office sought, and contact information. 3. The candidate certifies under penalty of perjury that they anticipate receiving less than $2,000 and spending less than $7,000 for the calendar year and that the form is true and correct to the best of their knowledge.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    2K views1 page

    VanPeborgh - 9.9.18

    Uploaded by

    The Union
    1. This document is a campaign finance disclosure form for a candidate or officeholder for calendar year 20XX. 2. It provides information about the candidate such as their name, office sought, and contact information. 3. The candidate certifies under penalty of perjury that they anticipate receiving less than $2,000 and spending less than $7,000 for the calendar year and that the form is true and correct to the best of their knowledge.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    Date Stamp

    Officeholder and Candidate


    Campaign Statement
    Short form Dilt<: of c,ccnor. it ap~iicable:
    0 Amendmtent (Explain Below) Ffl.ED For Official Use Only
    (Mor.th, Day, Year)

    ocr o9 zota
    .lllACER N,j...,..,,
    L Statement Covers Calendar Year 20 .

    2. Officeho!der or Candidate infmmatkm


    NAM~ o;. OHIC£;jClDF.~ OR C,MWHJA~·~ tt- 3. Office Sought or Held
    OF~ICE SOUQH-r Qij :-tf.UJ

    ,,1~ v~ ~fet 1){>7)'L( er D1fttt ro~


    ~
    jUR!SD,CT,QN (l.OCATION) OiSTR1C1 NuMtStK
    (,F APPUCA8LE)

    . . - ~ a . _,~-"'

    cn
    Af{f:A CO!JCl;)AYT,M;: PHDM· NUM8Gl CP flON/\,. h'\X I CMAiL/\ilDK::ss

    4. Committee Information
    List al! commtees Gf which you have knowledge that are primari\' formed to receive contributons or to make expend itures on behalf of yo;, r cand idacy.

    --------+-------------------------+------------------------
    COMMITI!:E NAME AND 1.D. NUMB!:R COMM!TTEE ADDRESS NAME OF TREASURER

    N~tuf

    5. Verlfkatfrm
    i dciclam under penalty of perjury that io ihe best of my know/edge i ariticipatc that I win receive icss than $?. ,000 and that I wili spencj \es:; U1an $7 ,000 during the calendar year and that l have
    used ail reasonable diligence in preparing this statement. i certify trider penalty of perjury under the laws of the State of California tr1at the foregoing is true and correct.

    """"''" q t1,- ( lg
    DAff
    Hy
    SiGNATURE OF Or-c!CEHOLDER OR CANDlDATE

    [. '_:arf~fm l
    --~,__J
    [_ ·P~i~! ~orm _ ] FPPC Form 470/470 Supplement (Ja n/20 16)
    FPPC Advice: advice@fppc. ca.gov (8661275-3772}
    www.fppc.ca.gov

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