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COVER PAGE <br /> '-r: ~clp;3nt Type or print in Ink. Dale Slump <br /> Committee <br />Campalgn Statement <br />(Government Code Sec§one 84200-84216.5) <br /> <br /> Statement covers period Data ol' election i~ ap plicable <br /> <br />1. Type of Recipient Committee: AIICommittees-Complete Peas 1,2,3, and7. 2, Type of Statement: <br /> ~fficeholder, Candidate ~ Primarily Formed Candidate/ ~ Pre-election Statement ~ Qua~erly Statement <br /> Controlled Committee Officeholder Committee ~emi-annual Statement ~ Special Odd-Year Report <br /> (AI~ Co.leto PaH 4.) (Aisc Complete Pa~ 6.) ~ Termination Statement ~ Supplemental Pre-election <br /> ~ Ballot Measure Comm~tee ~ General Pu~ose Committee <br /> ~ Amendment {Explain below) Statement - AUach Form 495 <br /> O Primari~ Formed O Sponsored <br /> O Controlled O Broad Based <br /> O Sponsored <br /> <br />3. Committee Information I.D.~R~ Treasurer(s) <br /> <br /> CITY STATE ZIP COOE AREACODFJPHONE CITY STATE ZIP COOE AREA CODFJPHONE <br /> <br /> OPTIONAl.; FAXlE-MAILADDRESS OPTIONAL: FAX/E-MAILADDRESS <br /> <br /> FPPC Form 460 (8/99) <br /> For Technical Assistance: 916/322-$660 <br /> State o! C~lifornla <br /> <br /> <br />