HomeMy WebLinkAbout470 01/12/2004 Officeholder and Candidate Campaign Statement - Short Form 2003 Charles AntosOfficeholder and Candidate
Campaign Statement —
Short Form
(Government Code Section 84206)
Type or print in ink.
Date of election if applicable: I Amendment (Explain Below)
(Month, Day, Year)'
1. Statement Covers Calendar Year 20 03 l
2. Officeholder or Candidate Information
NAME OF OFFICEHOLDER OR CANDIDATE
cHwecE5 ' WM 5
STREET ADDRESS
CITY
-/
ADDRESS
Date Stamp
1Y i 1
1
3. Office Sought or Held
OFFICE SOUGHT OR HELD
For Official Use
CryYC0uoe.f- Ns•411I
JURISDICTION (LOCATION) I DISTRICT, NUMBER
SrM,� w (IF APPLICABLE)
Ce
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
5. Verification
COMMITTEE ADDRESS
NAME OF TREASURER
FORM
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.
OR CANDIDATE
FPPC Form 450 (June /01)
FPPC Toll -Free Helpline: 866 /ASK -FPPC