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Type or print in ink. COVER PAGE - PART 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 /> <br /> NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE <br /> <br /> OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMeER IF APPLICABLE) BALLOT NO OR LETTER I JURISDICTION [] SUPPORT <br /> I <br /> [] OPPOSE <br /> <br /> RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Identify the controling officeholder, candidate, or state measure proponent, if any. <br /> HAME OF OFFICEHOLDER, CANDIDATE OR. PROPONENT <br /> <br /> Related Committees Not Included in this Statement: List any committees <br /> not included in this consolidated statement that are controlled by you or which are pdma~ly OFFICE SOUGHT OR HELD DISTRICT N O. IF ANY <br /> formed to receive cont~butions or to make expenditures on behalf of your candidac~ <br /> <br /> COMMITTEENAME LD. NUMBER 6. Primarily Formed Committee List names of o~ceholder(s) or candidafo(s) <br /> for which this committee is primarily formed. <br /> <br /> NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT <br /> NAME OF TREASURER CONTROLLED COMMITTEE? [] OPPOSE <br /> [] YES [] NO <br /> COMMI~i'EE ADDRESS STREET ADDRESS (NO P.O. BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT <br /> [] OPPOSE <br /> <br /> CITY STATE ZIP CODE AREA CODE/RHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT <br /> [] OPPOSE <br /> <br /> Altach continuation sheets if necessary <br />7. Verification <br /> <br /> I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the informatics'ontained herein and in the attached schedules <br /> is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is truend correct. <br /> <br /> Executed on ~/.=~0(~ BY ~//~NATURE OF TREASURER OR ASSISTANT TREASURER~ ~ <br /> Executed on <br /> °ATE By S,GNA, " O--TO CANO'DATE. S'AT MEASURE P"O"O"E"' O."ES"ONS'" EO 'OE" OF SPONSOR <br /> <br /> Executed on By <br /> DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANOIDATE, 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: 9161322-5660 <br /> State of California <br /> <br /> <br />