Officeholder and Candidate Campaign Statement – Short Form
470 CALIFORNIA FORM
Date Stamp
A
Date of election if applicable: (Month, Day, Year)
Amendment (Explain Below)
For Official Use Only
6/6/XX
2 1
XX
1. Statement Covers Calendar Year 20
.
3
3. Office Sought or Held
2. Officeholder or Candidate Information
OFFICE SOUGHT OR HELD
NAME OF OFFICEHOLDER OR CANDIDATE
STREET ADDRESS RaynaCole
City Council
DISTRICT NUMBER (IF APPLICABLE)
JURISDICTION (LOCATION) City of Oakmont
1212 Fourth Avenue
1
CITY
STATE
ZIP CODE 95443
Oakmont
CA
AREA CODE/DAYTIME PHONE NUMBER
EMAIL ADDRESS
707-555-1234
rcole@gmail.com
OPTIONAL: FAX
707-555-1235
4
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 COMMITTEE ADDRESS
NAME OF TREASURER
Friends Supporting Rayna Cole for City Council 20XX ID Number 1533XX
Gabriel Stoll
1618 C Street Oakmont, CA 95443
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5. Verification I anticipate that I will receive less than $2,000 and that I will spend less than $2,000 during the calendar year. I have used all reasonable diligence in preparing this Statement. I have reviewed this Statement and, to the best of my knowledge, the information contained in it is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
[Date Required]
[Signature Required]
By
Executed on
SIGNATURE OF OFFICEHOLDER OR CANDIDATE
DATE
FPPC Form 470/470 Supplement (Feb/2021) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov
Completing the Form 470 A Date of Election
If the candidate or officeholder is running in an election during the calendar year, indicate the month, day, and year of the election.
1 Period Covered The period covered is always the calendar year.
2 Officeholder or Candidate Information Provide the candidate/officeholder’s full name, street address (a business address may be used), and a daytime telephone number. A fax number and email address may also be provided.
Fair Political Practices Commission advice@fppc.ca.gov
Chapter 2.17
Campaign Manual 2 August 2023 Page 143
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