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� COVER PAGE �Recipient Committee Type or print in ink. Date Stamp � �. , Campaign Statement .- � • � Cover Page (Govemment Code Sections 84200-84216.5) page of Statemen co ers period Date of election if applicable: O (Month, Day,Year) For Official use Only from SEE INSTRUCTIONS ON REVERSE through � �+ -_ 1. Type of Recipient Committee: All Committees-Complete Parb 1,�,s,and 4. Z. Type of Statement: � ❑ Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ eelection Statement [] Quarte�ly Statement Q State Candidate Election Committee Committee �emi-annual Statement � Special Odd-Year Report Q Recall Q Controlled ❑ Termination Statement ❑ Supplemerttal Preelection (AlsoComp/etePartS) Q Sponsored (Also file a Form 410 Termination) Statement-Attach Form 495 �asocomWe�eaarte) � Amendment(Explain below) [�General Purpose Committee Q Sponsored � Primarily Formed Candidatel Q Small Co�tributor Committee Officeholder Committee Q Political PartylCentral Committee (AlsoCanpleteParf n 3. Committee Information �•D. NUMBER � Treasurer(s) COMMfTTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME O TR URER � ` /' I �ut.i-.-='��(.� {�� �r�etia�s c� I�ecQwoo�. C��( �14��- MAILINGADDRESS �T '�. ?.S d �ree STREET ADDRESS (NO P.O. BOX) CITY � STATE ZIP CODE AREA CODEIPHONE � �5 ,C� S�r�� w C' - CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASU R, IF ANY � C'c�Y � ��OG3 $ Scov MAILING A DRESS(IF IFF REN�N0.AND STREET OR P.O. BOX MAILIN ADDRESS f�� D� ��x ��3 .�3o f�l�.f�� S�r�� _ CIT STA1E ZIP CO�E AREA COOE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE � � � o -o s ,� �� C� � o� -3 - a OPTIONAL: FAX/E-MAIL AD RESS OPT NAL: FAX/E-MAII ADDRE S 4. Verification I have used all reasonable diligence in p�eparing 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 peryury under the laws of the State of California that the foregoing is true and correct. • executed on � ��_ ey ��-�-�Ci" p� ignaureofTreasureror ssistantTreasurer Executed on By p� Slgnature of Controtling 0lficeholder,Candidate,Stale Measure Proponent or Responsi6le Ofiicer of Sponsor Executed on By p� Slgnature of Conitalling Olficeholder,CencGdete,Sfate Measure Proponent Executed on gY p� Slgnature of ContrdlingOfficeholder,Candidate,State Measure ProponeM FPPC Forin 460(J8�48ry/OS) FPPC Toll-Free Helpline:866/ASK-FPPC(86612T6-3772) State of Callfornia