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HomeMy WebLinkAbout470 07/14/2004 Officeholder and Candidate Campaign Statement - Short Form 2004 Charles AntosOfficeholder and Candidate Campaign Statement — Short Form (Government Code Section 84206) Type or print in Ink Date of election if applicable: ❑ Amendment (Explain Below) (Month, Day, Year) 1. Statement Covers Calendar Year 20 Tiny f/ ao03 — J uNf 30j Zook 2. Officeholder or Candidate Information 3. Office Sought or Held NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (f- T *'V �� 'il-'e TT S STREET ADDRESS # � CITY I /E -MAIL ADDRESS C I TY COUnUe/li ILUGAI IUN) I� (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 To GL�iC� C#*e4.6;:7S_ .oVra7V5/ 1'2'q33 Cv / ADDRESS ' NAME OF 5. Verification I declare under penalty of perjury that to the best of my knowledge I anticipate that I will receive less than $1,000 and that I will spend less than $1,000 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. Executed on ST Z o 0q � DATE By SIGNATURE OF OFFICEHOLDER OR CANDIDATE FPPC Form 450 (June /01) FPPC Toll -Free Helpline: 666 /ASK -FPPC Wl. 4 a r. Ww'S 901%, CITY HALL 2J I EIGHTH STREE,f SEAL BEACH, C- ALIEORNIA 90740 (662)1431'252,7i • www.ciseal- *Nh.ca.us M E M O R A N D U M July 12, 2004 TO: Mayor and City Council FROM: City Clerk Forwarded is a copy of Form 470 to be used to file the off year Semi - Annual Campaign Statement that for this year will need to reflect the period July 1st, 2003 through June 30th, 2004. Even though you do not have a committee the qualifier to file this report is that the members of the Council receive more than $200 per month compensation. This Statement is due to be filed by Friday, July 30th, 2004 at 6:00 p.m. Encl.