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Type or print in ink. COVER PAGE - F~ART 2 <br />Recipient Committee <br />Campaign Statement <br />Cover Page Part 2 <br /> <br />4. Officeholder or Candidate Controlled Committee 5. Ballot Measure Committee <br /> NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE <br /> <br /> ~'ESlDEI~JTIAL/BUSlNEss ADDRESS (NO]~D STREET) ,,/ CITY STATE ZIP Identify the controlling officeholder, candidate, or state measure proponent, if any. <br /> <br /> Related Committees Not Included in this Statement: List any committees <br /> not included in this consolidated statement the t are controlled by you or which are primarily OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY <br /> formed to receive contributions or to make expenditures on behalf of your candidacy. <br /> <br /> COMMITTEE NAME I.D. NUMBER 6. Primarily Formed CommitteeList names of officeholder(s) or candidate(s) <br /> ~1~ -~ ~ ~ p~-.~t~ Iq~ I~(~ forwhlchthlscommltteelsprlmarllyformed. <br /> <br /> NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD <br /> NAME OF TREASURER I CONTROLLED COMMITTEE? [] SUPPORT <br /> <br /> I [].o <br /> NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD <br /> COMMITTEE~ADDRESS . EET ADDRESS (NO P.O. BOX) [] SUPPORT <br /> <br /> CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT <br /> <br /> Attach continuation sheets if necessary <br />7. Verification <br /> I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules <br /> is true and complete. I certify under penalty of perjury under the laws of th~oing is true and correct. <br /> <br /> Executedon 0 f'~/'- C.~ C~ By <br /> <br /> ~xecutedo. /" $/-~O Br ~ .-~ '"/"~'/'-4zap- -~' /~/~--~- <br /> DATE SIGNA~'~-~ uF u[JN~ING OFFICEHOLD~'R, CA~JDIDATE, STATE M~4t~SU~ROPONENT OR RESPONSIVe.OFFICER OF SPONSOR <br /> Executed on By <br /> DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT <br /> <br /> Executed on By <br /> DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT <br /> <br /> FPPC Form 460 (8/99) <br /> For Technical Assistance: 916/32~2-5660 <br /> State of California <br /> <br /> <br />