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Recipient Commitbee r ...�.- cov�Pa,c� <br /> Type or prir�t In ink. Date S�f'�i� <br /> Campaign Statement ' � �;T , '' � • i <br /> Cover Page -• _ <br /> (Govemment Code Secdons 84200-84218.5) ;' � <br /> Statement covars perfod Date af election if applGsabie: ,;�11 � � �012 P --�-�- °f � <br /> from � � � �1 ��Z (Month, Day,Year); rFor Omdal Use ony <br /> f <br /> : € <br /> SEE INSTRUCTIONS ON REVERSE d-� <br /> through � '� vU 1 L � � , � <br /> �_��,d..,,_w..._ . , <br /> 1. Type of Reciplent Committee: Ali Commltbess-Canpiets Parb 1,2.3,snd 4. 2. Type of Statement: <br /> ❑ Qfticeholder,Candidete ControNed Cammittee ❑ Primarily Formed Bellot Measure ❑ Praelection 3tatement ❑ Quarferly Statement <br /> Q Stete Cendidate Election Committee Commitbee [��mi-annuai Statement � gp���pdd.Year Report <br /> Q Recali Q Controqed <br /> (n�,�o,n�x,parta� � ��red ❑ Tertninatian Statement ❑ 3upplementai Preelection . <br /> ������� (Also file a Fam 410 Terminationj Statement-Attach Form 495 <br /> .> . [�General Purpose Committee ❑ Amendment(Explein bebu� <br /> Q Sponaored ❑ Pr(marily Fom�ed Candidate/ <br /> Q SmaN CoMributor Commkt� CNficeholder CommNtee <br /> Q Pol�ical Party/CeMral Commtttee ('4�0�°�s�� <br /> 3. Committee Informatlon �.D. NUMBER !�6 6 ��5��8� <br /> COMMI'1TEE NAME(OR CANOIDATE'S NAME IF NO COMMIITEE) NAME OF TREA&URER <br /> i'�l��f-�-he�, L.Pddy <br /> ��(Re��S O r" � � �� G MAILIN�AODRESS <br /> ��(Nba� Z7c� 7� ,�,Sfle�-� <br /> STREET ADDRESS(NO P,O.BOX) CITY STATE ZIP CODE AREA CODFJPHONE <br /> �.?s D ��f-�e c� �'e.c��,.oJc� C��,, C� cl`�o(�3 CoS��366-361.c� <br /> CITY STATE ZIP CODE AREA COQE/PHONE AM S 18 AT�11' ,� <br /> Rt�.wdaa� C��f� C/�r �`lblo3 (056�3�(v-._3�� C�-t c,� ev� v��e .�'co�e <br /> MAILING ADDRESS(IF DiFFERBNn NO.ANO STREET OR P.O.BOX MAILING AODRESS/ <br /> �o__�ax � 53 _ 33o A I de� s��eet <br /> CITY STATE ZIP CdDE AREA CODElPHONE CITY STATE 21P CODE AR CODE/PHONE <br /> c,��� G ' [./-� ��fts�3-o8�3 /�ec��aad C�� . �,4 � �'i�/2�� 3 65� 3G8-y28`� <br /> OPTIONAL: FAX!ErMAII AD ESS OPTIONAL: FAX/E-AM41L AD RE8& <br /> 4. Vertflcation <br /> I have used aU reasonable di�gence in prepadng and review(ng this statement a�d to the best of my knowleclge the intormetion contained herein and fn!he attached schedules is true and complete, I certiiy <br /> under penatly of perjury under the lawa of the State of Califomia that the foregofng is true and correct. <br /> Facscutsd on �- � C� " � ✓ Zr r G /l�Ci� " �� <br /> By <br /> neturs or <br /> Exeaitsd on gy <br /> � , � taM a e� ot ponror <br /> F�cecuted on gy <br /> sqn�nxs . . <br /> Euecutsd on gy <br /> qna�sot . .SteteMeakra PpPC Fortn 460(Janwry/067 <br /> PPPC ToN-Fre�Helpllne:B8A/ASK-FPPC(888/2�6-5772� <br /> sate ot caltrom�a <br />