Bracco, Dion - Voluntary Campaign Expenditure Ceiling Statement •
I
OM�DAUG - 4 2022CITY OF GILROY ILROY CITY CLERK'S OFFICE
VOLUNTARY CAMPAIGN EXPENDITURE CEILIN
Who Uses this Form: Filing Location
Candidates for local office must file this form.
Original form to:
Candidate Information Thai Nam Pham, City Clerk
The candidate name, address, office sought, and Office of the City Clerk I City of Gilroy
verification must be completed. 7351 Rosanna Street, Gilroy, CA 95020
Deadlines Delivery Method
This declaration must be completed and filed before This declaration must be filed in person or sent by first class
accepting campaign contributions from other persons in mail or overnight delivery.
connection with the identified election.
Note: This form may be emailed to Thai Nam Pham at
thai.pham@cityofgilroy.org followed by the original mailed
within 24 hours.
I. Candidate Information
Name of Candidate Daytime Telephone No. Fax No. Email Address
-Pusn 13ra.cc-y (YyPj f�2 z 117 ton �r-cc..r>(Q q w�i���cok"
Mailing Address City State Zip
e4 1301 1 y
Office Sought
Ciry Cov1"C- I
11. Declaration Pursuant to City of Gilroy Ordinance No. 2015-07
Election Date: 11/8/2022
(Check Only One Box)
I accept the voluntary expenditure ceiling for the election stated above which establishes a voluntary expenditure
�j ceiling for candidates and their controlled committees not to exceed $1.00 per resident for each election in the
�1 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.
❑ I 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 , 2022 IG-�
(month, day) (Signature of Candidate)