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Type or print in ink. COVER PAGE - PART <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 BALLOT MEASURE <br /> NAMEOFOC;i " '; E <br /> OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER I JURISDICTION [] SUPPORT <br /> <br /> RESIDENTIAIJBUSlNESS ADDRESS (N RE STATE ZiP Identify t he controling officeholder, candidate, or state measure proponent, if any. <br /> . ood NAMEOFOFF,OEHOLDE..CAND,OATEOR. FROFONE.T <br /> Related Committees Not Included in this Staterne~. <br /> Est any committees <br /> not included in this consolidated statement that are controlled by you or v~3ich are ptfma~ly OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY <br /> formed te receive contrlbufions or to make expenditures on behalf of your candidacy. <br /> <br /> NAMECOMMITTEE NAMEoF TREASURER CONTROLLEDI'D* NUMBER[] YES COMMITrEE?[] NO 6.NAME forwhlchthlscommlttaetap~lma~lyformed.PrimarilYoF OFFICEHOLDERFOrmedoR CANDIDATECOmmittee OFFIcEListname$°f°~Tceh°lder(s)°rcandidate($)SOUGHT OR HELD I I[]OPPosESUPPORT <br /> NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD <br /> COMMITrEEADDRESS STREET ADDRESS (NO P.O. BOX) [] 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 Attachcon#nuationsheetsifnecessal~ <br /> <br /> I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the informaticcDntained herein and in the attached schedules <br /> is true and complete. I ceAify under penalty of perjury under the laws of the State of.~alif~-~at the foregoing is truand correct. <br /> <br /> Executed on ~-'~'~ / ~''~/ By <br /> DATE SURER OR ASSISTANT TREASURER <br /> Executed on ~ ~ / ~ t By <br /> DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT OR RESPONSIBLE OFFICER OF SPONSOR <br /> <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: 916/322-5660 <br /> State of California <br /> <br /> <br />