Laserfiche WebLink
Officeholder, Candidate, TV~ or print in ink. COVER PAGE- LO~*~G FORM <br />and Co.ntrolled Committee _ ~.1~ Statement covers period ] DateStamp <br />Campmgn Statement -- Long Form ~ . ~~ ~,om /0'22 ~ ~ <br /> (Government C~e S~ions.2~-842,6.5) [A~' // <br /> SEE INSTRUCTIONS ON REVERSE I - / ~ through ~ ,, ~ <br /> C~(ko~thefoll~ing~xestol~tethety~of;tatement~ingfi~: Date~nH~: ~ ~ ~ ~ ~ ~ <br /> ~ Supplemental Pre~l~ion Statement (A~ach a completed Form 495 to this statement.) <br /> <br />~ Termination Statement (A~ach ~ comp eted Form 415 to this ~atement ) <br />I, Officeholder. Candidate. and Controlled Commi~ee II Other Committee~ Not ~<l~ii <br /> Included in this Statement c~m~ees~ti~l~din~ ........ ona;e~mm ~rec~olled~y~a~anyment: <br /> NAM~F OFF~EHOLDER OR ~N~ATE e~m~es of ~h you have knowl~e that are ~marl~ f~ed to recel~ <br /> <br /> NAME OF TRE~URER~ c~,,,~ <br /> <br />Ill Verification <br /> I have u~d all reachable diligence in preparing thi~tatement. I have revi~ed the ~atement and to the ~ of my k~ge the information con. ned herein <br /> true and compile. ~e~i~ u~er ~nil~ of ~r~under the la~f th~te of California that the forgoing is t~ ~e~. ~ ~ - - <br /> <br /> CnY AND STATE / S~NATURE ~ T~ASU~R <br /> An officeho~r m ~ate who controls a ¢omm~ must al~ ver~ t~ campaign ~teme~. I have used all reasonable diligence and to the ~ of my knowledge the treasurer has us~ all <br /> reasonable dilige~e in pre.ring this ~atement. I have reviewed the statement and to the ~ of my kn~l~ge the information contain~ herein and in the a~ached ~hedules is true and <br /> <br /> Executed on At By <br /> Executed on At By <br /> <br /> <br />