470 Campaign Statement 2012 Amendment Officeholder and Candidate SHORT FORM
Type or print in ink.
Campaign Statement— � U v ' ' �
Short Form
(Government Code Section 84206) Date of election if applicable: �X Alllelldlllefit (Explain eelow) or official Use Only
(Month,Day,Year)
Prior version fi►ed showed F�B � �4�3
CY2013 rather than CY12
i
1. Statement Covers Calendar Year 20 12 .
2. Officeholder or Candidate Information 3. Office Sought or Held
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD
Rod Sinks City Council Member
STREET ADDRESS JURISDICTION{LOCATION) DISTRICT NUMBER
(IF APPLICABLE)
Cupertino
CITY STATE ZIP CODE
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$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 alty of ' ry under e laws of the State of California
that the foregoing is true and correct. ,
Executed on 1/31/13 By /�
DATE SIGNATURE OF OFFICEHOLDER OR CANDIDATE
FPPC Form 470/470 Supplement (January/OS)
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