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iDfficeholder, .......Candidate, Typ* or print in ink. stetement covers period T Date,Stamp ~COVER PAGE - LONG FORM <br />;,na Co?trollea LommltTee ~ <br />~Campalgn Statement -- Long Form <br />i[G4w~nmentCodeSectmm~4Z00-84216-5) L/~_~/. ~ ~ ~ ~.. o . I <br /> <br /> r'i ,..-.~.c~.st.te.n...t I "~=~'Y'"" Ilflll ,.. , ~ Illlll I <br /> [] SuplMemente' Pre-Mection Statement (Attach, COral)feted Form 495 to th, st&tomen~.) I <br /> r'i SI)eClelodd-Ye~rCampa~nR4pon I //- -7- ~ I I I IU I I <br /> ~Semi~nnullSgtement J '' ' ' I ~l I i <br /> '~ Ttrminat~n St~tament (Attach ? comldetod Form/,15 to th:s statoment.) J . <br /> , [Hticeholder Candidate, &nu Controlled Co,,,,,,,,Lee II Other CO,,,,,.L~==. <br /> &~l~ded in ~tis Statement <br /> ~ME Of OfflC~IIO~D~ O~ CANDiZA~ <br /> <br /> COMMITTEE NAME ' I LD. NU~N~ QTY <br /> , ,,. ~S$ <br /> <br /> i h4n~ u~ed ~11/dillnce i. pceg4q tim statement, i h~ve IivW the statement ind to the best of my ~l14/~e the intotmtmfl coflteJlid hM~n end i ~ I W I <br /> tree end ComM. I _~tify ~nder penalty of i;~ja~ ~u rthe~ws oft~e State _~ Cali/~nm that the hx~ Is~e~ect. <br /> Elilcuted o~ ..M~l~il... At azv A.D ST&lr By <br /> <br /> M O~t M candidate who contrail i comndttee must II1o verily the c~m~n ~tamem I have u~ed ell ~elto~ble diPgence end to the b~s~ of mY kn°wlM~g~ h tfelliu~r has used iII <br /> re~o~bie dibge~4 in p~parmg th~ ttetement. I ha~e revmwed the statement and to the be~t of my knowMdg4 the inlMmlt~ ~ont-med hereto and m the itta~ted ~ B tru~ end <br /> <br /> At By <br /> <br /> <br />