Shebreh Kalantari-Johnson Form 460 4.24.2022 to 5.21.2022

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4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. I certify
under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
By Signature of Treasurer or Assistant Treasurer
By Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor
By Signature of Controlling Officeholder, Candidate, State Measure Proponent
By Signature of Controlling Officeholder, Candidate, State Measure Proponent
Executed on Date
Executed on Date
Executed on Date
Executed on Date
SEE INSTRUCTIONS ON REVERSE
Date of election if applicable:
(Month, Day, Year)
Recipient Committee
Campaign Statement
Cover Page
For Official Use Only
Page of
COVER PAGE
CALIFORNIA
FORM
Date Stamp
3. Committee Information
COMMITTEE NAME (OR CANDIDATE’S NAME IF NO COMMITTEE)
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
Statement covers period
from
through
(Government Code Sections 84200-84216.5)
1. Type of Recipient Committee: All Committees – Complete Parts 1, 2, 3, and 4.
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Treasurer(s)
NAME OF TREASURER
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
460
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
I.D. NUMBER
2. Type of Statement:
Preelection Statement
Semi-annual Statement
Termination Statement
(Also file a Form 410 Termination)
Amendment (Explain below)
Quarterly Statement
Special Odd-Year Report
Supplemental Preelection
Primarily Formed Ballot Measure
Committee
Controlled
Sponsored
(Also Complete Part 6)
Officeholder, Candidate Controlled Committee
State Candidate Election Committee
Recall
(Also Complete Part 5)
Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 7)
General Purpose Committee
Sponsored
Small Contributor Committee
Political Party/Central Committee
Statement - Attach Form 495
www.netfile.com
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
FPPC Form 460 (Jan/2016)1 15
04/24/2022
05/21/2022 06/07/2022
X X
143899
Shebreh Kalantari-Johnson for Santa Cruz County Supervisor 2022
Santa Cruz CA 95060
shebreh4santacruz@gmail.com
Margaret Mathias
Santa Cruz CA 95062
moopops@gmail.com
05/26/2022 Margaret Mathias
05/26/2022 Shebreh Kalantari-Johnson
E-Filed
05/26/2022
10:10:36
Filing ID:
203876196

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