BARNEICH, KRISTEN - FORM 470 - 2019 Officeholder and Candidate Date Stamp
RECEIVED CALIFORNIA 470
Campaign Statement - FORM
Short Form Date of election if applicable: ❑ Amendment Explain.Bevd?kFor Official Use Only
(Month,Day,Year) JUL 1 4 2019
CITY CLERK'S OFFICE
CITY OF ARROYO GRANDE
1. Statement Covers Calendar Year 20 101
2. Officeholder or Candidate Information 3. Office Sought or Held
NAME OF OFFICEHOLDER OR CANDIDATE • OFFICE SOUGHT 0 HELD
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STREETADDRESS JURISDICTION LOCATION) DISTRICT NUMBER
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CITY ,) STATE I' ZIPCODE // / 1 ('/v C CPr / l.11-i2v
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AREA CODE/DAYTIME5HONE NUMBER OPTIONAL: FAX!E-MAILADDRESS
80S -- L �2) ._ 94OL
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
5. Verification
I declare under penalty of perjury that to the best of my knowledge I anticipate that I will receive less than 82 ,000 a that I will spend less t, ,0 Ing t'- .lendar year and that I have
used all reasonable diligence in preparing this statement. I certify under penalty of perjury under the laws.of the tg Cal'Ifornia that the oregoing is t - .n.
FPPC Form 470/470 Supplement (Jan/2016)
' fi. ' ;p FPPC Advice: adviceCfppc.ca.gov (366/275-3772)
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