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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 /> NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE <br /> <br /> OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICAJ~LE) BALLOT NO. OR LETTER JURISDICTION [] SUPPORT <br /> [] OPPOSE <br /> <br /> RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZiP Identify the controlling officeholder, candidate, or stata measure proponent, if any. <br /> NAME OF OFFICEHOLDER, CANDIDATE OR, PROPONENT <br /> <br /> Related Committees Not Included in this Statement: List any com=ittoes <br /> not included in this consolidated statement that are controlled by you or which are primarily OFFICE SOUGHT OR HELD DISTRICT NO. ~F ANY <br /> formed to receive contrfbutlons or to make expenditures on behaff of your candidacy. <br /> <br /> DOMMn-r~EN~E ,.D. NUMBBR 6. Primarily Formed Committee Llstnamesofomceholder(s)orcandldafo(s) <br /> for which this committee is prfmaHly 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~rEEADDRESS STREETADDRESS (NOP.O. BOX) NAMEOFOFFICEHOLDERORCANDIDATE OFFICESOUGHTORHELD [~ SUPPORT <br /> OPPOSE <br /> <br /> CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT <br /> [] OPPOSE <br /> <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 trna and complete- ~e/r~,;;~r penalty °f perjury under the laws °f the State~/~h~ the f°re~:iue and c°rrect. <br /> Executed on-'~/~ ~,~ '~ ' '~/"~B~? By ~--~ y~NATU RE O F TP-E~SURER OS ASS,ST^NT TRE~SU P,~R <br /> <br /> FPPC Form 460 (8/99) <br /> <br /> <br />