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CQVER PAGE <br /> ~ "'"' +..ec...en. Committee Type or print in ink. Date Stamp <br /> Campaign Statement <br /> Cover Page c:~-% <br />(Government Code Sections 84200-84216.5) <br /> I Statementc°versperi°d [DateOfelectiOnifapplicab FEB 2 5 ~00g Page ~ XfrOm - -- <br /> /(~3~ /~. (Month, Day, Year) __ of__ <br /> <br /> For Official Use Only <br /> SEE INSTRUCTIONS OH REVERSE through~'~- ] "~'~X / (~X C'TY OFc,TYF{EOWOOOcLE2K <br /> <br /> 1. Type of Recipient Committee: A. Committees - Complete Paris 1, 2, $, and 4. 2. Type of Statement: <br /> lfflceholder, Candidate Controlled Committee [] Ballot Measure Committee [] Preelection Statement <br /> State Candidate Election Committee O Pdmadly Fon'ned '~"-~' Semi-annual Statement [] Quarterly Statameni <br /> [] Special Odd-Year Report <br /> O Recall O Controlled '[] Termination Statement [] Supplemental Preelection <br /> (Also c.~mptete Part s) O Sponsored <br /> (A~o ccm~ P~ 6) "~..~mendment (.Explain below) . Statement - Attach Form 495 <br /> [] O Sponsored [] Pdmadly Formed Candidate/ <br /> O0 Small Co.ffihutar Commitlee Officeholder Co~millee <br /> ~oli~cal Party/Central Committeo Cu~o c~.~t~ ~t r) ~ · <br /> <br /> COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITrEE) NAME OF TREASURER <br /> <br /> STREET ADDRESS (NO RO. BOX) * C[~Y STATI~ ZIP CODE AREA CODE/PHONE <br /> · STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY <br /> <br /> MAILING ADDRESS (IF DIFFERENT) NO ~,ND STREET OR PO. aox MAILING ADDRESS <br /> <br /> CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE <br /> OPTIONAL: FAX / E-MAIL--DRESS <br /> <br />4. Verification <br /> I have used all reasonable diligence in preparing and reviewing this statement and in the best of my knowleqLqe the information contained herein and in the attached schedules is true and compieta. I <br /> certif'/under penally of perjury under the laws of the State of California that the foregoing is true an~rr~ <br /> <br /> Executed orl By ~ surer <br /> ~ ~nature of TreaEucer or ,~istailt Trea <br /> <br /> Executed on Date By Signature of Cc~ r~. State M~as~re Pmporent or Responsible <br /> Executed on By <br /> Date ~.~.at~re of Con~ng Officelx~ide~, Candidate, State Mead,re prof~ment <br /> <br /> Executed on By <br /> Date Signature of Coq~rc4ting Ofl~ehoEder, Candidate, SEato Meas~e Proponent FPPC Form 460 tJ uno/01 ) <br /> FPPC Toll-Free Helpline: 8661ASK-FPPC <br /> State of California <br /> <br /> <br />