470 Annual
2005
28
JUL
(Explain Bel
Type or print in ink.
D Amendment
Date of election if applicable:
(Month, Day, Year)
Officeholder and Candidate
Campaign Statement -
Short Form
(Government Code Section 84206)
ERTlNG CITY CLEF!lK
3. Office Sought or Held
OFFICE SOUGHT OR HELD
04
Officeholder or Candidate Information
NAME OF OFFICEHOLDER OR CANDIDATE
Year 20
Covers Calendar
Statement
1
2.
Councilmember
JURISDICTION (LOCATION)
City of Cupertino
Dolores Sandoval
STREET ADDRESS
DISTRICT NUMBER
(IF APPLICABLE)
STATE ZIP CODE
CA 95014
OPTIONAL: FAX/E·MAILADDRESS
10720 Alderbrook Lane
CITY
Cupertino
AREA COOEIDAYTIME PHONE NUMBER
408/725-8939
of your candidacy
NAME OF TREASURER
/mow/edge that are primarily formed to receive conlributions or to make expenditures on behalf
NUMBER COMMITTEE ADDRESS
Committee Information
List all committees of which you have
COMMITTEE NAME AND 1.0.
-
5. Verification
4.
I declare under penalty of pe~urythat 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. Gd
2005
July 25,
DATE
SIGNATURE OF OFFICEHOLDER OR CANDIDATE
FPPC Form 470/470 Supplement (January/05)
FPPC Toll-Free Helpline: 866/ASKMFPPC (8661275-3772)
By
Executed on