Laserfiche WebLink
Officeholder and Candidate <br />Campaign Statement — <br />Short Form <br />Date of election if applicable: <br />(Month, Day, Year) <br />November 8, 2022 <br />1. Statement Covers Calendar Year 20 22 . <br />11 Amendment (Explain Below) <br />2. Officeholder or Candidate Information 3. Office Sought or Held <br />NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD <br />Kelly J Chastain <br />STREETADDRESS <br /> <br />CITY STATE ZIPCODE <br /> <br />AREA CODE/DAYTIMEPHONE NUMBER OPTIONAL: FAX/ E-MAIL ADDRESS <br />909- <br /> Member <br />Distrist <br />Date Stamp <br />RECEIVED <br />AUG g` -2022 <br />FFICE OF THE <br />4. Committee Information <br />List all committees of which you have knowledge that are primarily formed to receive contributions or to make expenditures on behalf of your candidacy. <br />COMMITTEE NAME AND I.D. NUMBER <br />5. Verification <br />COMMITTEE ADDRESS <br />(IF APPLICABLE) <br />2 <br />NAME OF TREASURER <br />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 <br />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. <br />Executed on l.) Ly S f 3 1 2 <br />DATE <br />By <br />SIGNATURE OF OFFICEHOLDER OR CANDIDATE <br />FPPC Form 4701470 Supplement (Jan/2016) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />wwrw.fppc.ca.gov <br />