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Type or print in ink. <br /> RecipientCommittee <br /> Campaign Statement <br /> Cover Page—Part 2 <br /> 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee <br /> NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE <br /> OFFICE SOUGHT OR HELD(INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) <br /> RESIDENTIALlBUSINESS ADDRESS (NO.AND STREET) CITY STATE ZIP <br /> Related Committees Not Included in this Statement: Llstanycommlttaaa <br /> not lncJudad!n thls stat�ment that ae+r controlled by you or are prlmar!!y formad to recelva <br /> contrlbudons or maka�xpanditures on baha/f of your candldecy. <br /> COM M ITTEE NAME <br /> NAME OF TREASURER <br /> COMM <br /> I.D. NUMBER <br /> CANTROLLED COM M ITTEE? <br /> ❑ YES ❑ NO <br /> STREET ADDRESS (NO P.O.BOX) <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> COMMITTEE NAME <br /> NAME OF TREASURER <br /> COMMITTEEADDRESS <br /> I.D. NUMBER <br /> COVER PAGE-PART 2 <br /> Page 2 of? <br /> ❑ SUPPORT <br /> ❑ OPPOSE <br /> Identify the controlling ofiiceholder, candidate, or state measure proponent, if any. <br /> NAME OF OFFICEHOLDER,CANDIDATE,OR PROPONENT <br /> OFFICE SOUGHT OR HELD <br /> DISTRICT NO. IF ANY <br /> 7. Prima�ily Formed Candidate/Officeholder Committee Llst namas of <br /> of/lcaho/dar(i)or cRndldata(sJ for whlch th/s commlttaa Ja prlmarlly form.d. <br /> NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD <br /> NAME OF OFFICEHOLDER OR CANDIDATE I OFFICE SOUGHT OR HELD <br /> NAME OF OFFICEHOLDER OR CANDIDATE �OFFICE SOUGHT OR HELD <br /> CONTROLLEDCOMMITTEE"? NAME OF OFFICEHOLDER OR CANDIDATE I OFFICE SOUGHT OR HELD <br /> � YES ❑ NO <br /> STREET ADDRESS (NO P.O.BOX) <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> Attach contlnuatlon sheets if necesaary <br /> ❑ SUPPORT <br /> � OPPOSE <br /> ❑ SUPPORT <br /> �OPPOSE <br /> � SUPPORT <br /> ❑ OPPOSE <br /> ❑ SUPPORT <br /> � OPPOSE <br /> FPPC Form 480(January/O6) <br /> FPPC Toll-Free Helpllne:866/ASK-FPPC(866/27b3772) <br /> State of Calffornla <br />