Bernstein Chargin, Jan - Gilroy Expenditure Ceiling StatementCSC ODD
AUG 12 2022
CITY OF G I L RO GILROY CITY CLERICS OFFICE
VOLUNTARY CAMPAIGN EXPENDITURE CEILING STATEMENT
Who Uses this Form:
Candidates for local office must file this form.
Candidate Information
The candidate name, address, office sought, and
verification must be completed.
Deadlines
This declaration must be completed and filed before
accepting campaign contributions from other persons in
connection with the identified election.
I. Candidate Information
Name of Candidate
Jan Bernstein Chargin
Mailing Address
Daytime Telephone No.
(
II. Declaration Pursuant to City of Gilroy Ordinance No. 2015-07
Election Date: 11/8/2022
(Check Only One Box)
1 accept the voluntary expenditure ceiling for the election stated above which establishes a voluntary expenditure
ceiling for candidates and their controlled committees not to exceed $1.00 per resident for each election in the
City in which the candidate is seeking elective office (which is $59,520 for this election). I also understand that
the total amount contributed by any single source may not exceed $750.00 per election.
do not accept the voluntary expenditure ceiling for the election stated above and understand that it shall be
prohibited to accept any contribution over $100.00 from any single source during this election.
I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct and understand
that it shall be noted on the ballot that I have voluntarily agreed to the expenditure ceiling.
Executed on August 8, 2022
, 2022
(month, day) / > Candidate)