CA Form 470 Officeholder and Candidate Campaign Statement - Brian Campbell RECEIVED
CITY OF RANCHO PALOS VERDES
JUN 27 2016
Officeholder and Candidate ' •• r r L!:LII-O R N I A
9
Campai n Statement- CITY CLERK,S O FORM 4
Short Form Date of election if applicable: 0 Amendment(Explain Below) For Official Use Only
(Month,Day,Year)
t I
1. Statement Covers Calendar Year 20 16 •
2. Officeholder or Candidate Information 3. Office Sought or Held
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
Brian Campbell City Councilman
STREET ADDRESS JURISDICTION(LOCATION) DISTRICT NUMBER
(IF APPLICABLE)
Rancho Palos Verdes
CITY STATE ZIP CODE
AREA CODEIDAYTIME PHONE NUMBER OPTIONAL FAX/E-MAIL ADDRESS
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$2,000 and that I will spend less than$2,000 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 S S. - California that I. .egoing is true and correct.
Executed onor 49';7,__627e1K___ By
ATE
FPPC Form 470/470 Supplement(Jan/2016)
FPPC Advice:adviceetppc.ca.Sov(866/276-5772)
www.fppc.ca.gov
Instructions for Completing CALIFORNIA 470
Form 470 Supplement FORM SUPPLEMENT
Form 470 Supplement: Office Sought
If an officeholder or candidate files the Form • Enter the title of the office sought;
470 for an election year and later receives • the district number,if any;and
contributions(including monetary and non- • the date of the election.
monetary contributions,loans,and the candidate's
personal funds)totaling$2,000 or more or makes Date Contributions/Expenditures Were Made or
expenditures totaling$2,000 or more during the Received:
same calendar year,the officeholder or candidate Enter the date monetary or non-monetary
must send a written notice within 48 hours. Use contributions totaling$2,000 or more(including the
the attached Form 470 Supplement or follow the candidate's personal funds)were received or the
instructions below for preparing the notice. date expenditures of$2,000 or more were made.
When to File: Amendments: If you are filing an amendment to a
The notice must be sent within 48 hours of previously filed statement,give a brief explanation
receiving contributions totaling$2,000 or more or of the amendment.
making expenditures of$2,000 or more.
Note: Once an officeholder or candidate reaches
Method of Delivery: the$2,000 threshold in receipts or expenditures,
The notice must be sent by guaranteed overnight in addition to filing the Form 470 Supplement,
delivery service,personal delivery,fax,or email. other forms are required. See FPPC Campaign
Regular mail may not be used. Disclosure Manual 1 for state candidates or
Manual 2 for local candidates.
Where to File:
• Secretary of State's Office;
• local filing officer with whom the officeholder/
candidate is required to file the originals of his/
her campaign statements;and
• each candidate seeking the same office.
Contact your filing officer for candidate addresses.
Officeholder/Candidate Information
Enter the officeholder/candidate's full name,
residential or business address and daytime
telephone number.
FPPC Form 470/470 Supplement(Jan/2016)
FPPC Advice:advice.fppc.ca.gov(866/275-3772)
www.fppc.ca.gov