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CA Form 470 Officeholder and Candidate Campaign Statement - Michele Carbone Officeholder and Candidate Campaign Statement— D 'CEIV CALIFORNIA 470 Short Form CITY OF RANCHO pA I FORM Date of election if a licable: L pp El Amendment (Explain Below) For Official Use Only (Month,Day,Year) SEP 2 6 2022 11/08/2022 CITY CLERK' S OFFICE 1. Statement Covers Calendar Year 20 22 2. Officeholder or Candidate Information 3. Office Sought or Held NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD Michele Patrick Carbone Rancho Palos Verdes City Council STREET ADDRESS JURISDICTION(LOCATION) DISTRICT NUMBER 2 Barkentine Road Los Angeles (IF APPLICABLE) CITY STATE ZIP CODE Rancho Palos Verdes CA 90274 AREA CODE/DAYTIME PHONE NUMBER OPTIONAL: FAX/E-MAIL ADDRESS 424-445-8906 carbone4RPVCC@gmail.com 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 None 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 State of California that the foregoing is true and correct. CaAAC5' 09/24/2022 Executed on By DATE SIGNATURE OF OFFICEHOLDER OR CANDIDATE •r_ FPPC Form 470/470 Supplement(Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov