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Office. holder, Candidate, COVER PAGE - LONG FORM and Cdntrolled Committee Type or print in ink. Statement covers period Dale Stamp Ca'mpai§n Statement - Long Form from////~:~ CAMFORN A, ,1994 ~OR~' ~:~ (Gov, e~nment Code Sections 84200-84216.5) ~ ~" ~'~:;~ Check one of the following boxes to indicate the ~pe of statement being filed: Date of election if applicable: For Official Use Only ~ Pre-die.on Statemenl (Month, Day, Year) OCT 5 Supplemental Pre-election Statement (Aaach a completed Form 495 to this statement.) ~ Special Odd-Yea, Campaign Re~, ~ Semi-annual S~tement CiTY OF REDWOOD CWY ~ Te~inati0n Statement (A~ach a completed Form 415 to Ibis statemenL) CITY CLERK I Officeholder Candidat~ and Controlled Cgmmi~ee II Other Commi~ee~ Not Included in this Statement: Included n this Statement co~,~i~ees not included in this consolidated statemen~ ~hat are con~olled by you and NAME OF OFFICEHOLDER OR CANDIDATE any commiNees of which you have knowledge that are primarily formed to receive --~ ~ ~ ~ ~ contributions or to make expenditures on behalf of your candidacy. COMMITTEE NAME OFFICE SOUGHT OR HELD (rNCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) 1.0 NUMBER NAME OF TREASURER CONTROLLED COMMITTEE'/ COMMITTEd NAME / I.D. NUMeER CITY STATE ZiP CODE AR~A COD~/DAYTIME PHONE COMMITTEE ADDRESS(NO AND STREET} I.D NUMeER NAME OF TREASURER CONTROLLED COMMITTEE'/ STATE ZIP CODE PERMANENT ADDRESS OF TREASURER (NO AND SIREET} CI'~z~ W0~ ~ff~ STATE~ 'ZIP CODd~V~ AREL'- m -g~;~-/g//cODE/DAYTIME PHONE Attach additional information O. app.priately ,abeledcontinuatio. sheets. III Verification I have used all reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my knowledge the information conlained herein and in the aaached schedules is true and complete. I ced/fy under penal~ of perju~ under the laws o[ the Stal~ of Call.mia that the. foregoing is true and An officeholder or candidate who controls a commiflee must also verify the campaigo statement. I have used ~ reasonable diligence and to the best of my knowledge [he treasurer has used all reasonable diligence in preparing this statement. I have ~eviewed lhe statemenl and to the best of my knowledge the~rm~i~c~tained herein and in the altached schedules is rue and complete. I ceQify under penalty of perju~ under the laws of the State of California that lhe foregping is tru~ and correct. / ~ DATE CI~ AND S}ATg f - ~ ~ ~ S[GNATURE OF CANDIDAT~OFFICEHOLDER Executed on Al By OATE CIIY AND S~A~E SIGNATURE O¢ CANDIDAI ~O~ICEHOLDER Executed on At By [:)ATE C~] Y AND SIAl [ SIGNATURE OF CANOIDATE~FFIC E HO[ DER FOR INFORMAlION REQUIRED TO BE PROVIDED TO YOU PURSUANT ~O T HE INFORMAIION PRACTICES ACT OF 1977, SEE INFORMATIO~ MANUAl ON CAMPAigN DISCLOSURE PR~V~J~LITICAL State of California Fair Political Practices Commission