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HomeMy WebLinkAbout470 04/15/2013 Officeholder and Candidate Campaign Statement - Short Form 2012 Ellery A DeatonOfficeholder and Candidate Campaign Statement — Short Form (Government Code Section 84206) Type or print in ink. Date of election if applicable: (Month, Day, Year) N/A 1. Statement Covers Calendar Year 2012 2. Officeholder or Candidate Information NAME OF OFFICEHOLDER OR CANDIDATE ELLERY A. DEATON STREETADDRESS 211 8TH STREET CITY STATE ZIPCODE SEALBEACH AREA CODE /DAYTIME PHONE NUMBER 562 - 431 -2527 CA 90740 ❑ Amendment (Explain Below) OPTIONAL: FAX /E -MAIL ADDRESS APR 15 2013 CITY CLERK CITY OF SEAL SEE 3. Office Sought or Held OFFICE SOUGHT OR HELD CITY COUNCIL For Official Use JURISDICTION (LOCATION) DISTRICT NUMBER (IFAPPLICABLE) SEAL BEACH I ONE 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 . NUMBER am N/A 5. Verification N/A N/A NAME OF TREASURER 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 `� 113 By DATE / S I G NATURE OF OFFICEHOLDER OR CAN DI DATE FPPC Form 470/470 Supplement(January /08) FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661275 -3772)