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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 /> NA~C E H/~R~R/~ATE NAME OF BALLOT MEASURE <br /> OF ~.ICE~-~..~L~ ~--~SO~JGHT OR HELD (INCLUDE~_~.. ~- ~'J'~LOCATION~.AND~-~DISTRICT ~.~ ~[-~ ~ ~NUMBER IF A~PP~ LIC~BLE) ~_ V~ ~.~ ~J~ BALLOT NO. OR LETTER JURISDICTION [~] OPPOSE[] SUPPORT <br /> RESIDENTIAL/BUSINESS ADDR ESS ~NO AND STREET) CITY STATE ZIP Identify the controling officeholder, candidate, or state measure proponent, if any. <br /> ~.~ NAME OF OFFICEHOLDER, CANDIDATE OR, PROPONENT <br /> <br /> Related Committees Not Included in this Statement: Ltst any committees <br /> not included in this consolidated statement that are controlled by you or which are primarily OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY <br /> formed to receive contributions or to make expenditures on behalf of your candidacy. <br /> <br /> NAMECOMMITTEE OF TREASURER NAME CONTROLLEDI'D'[]NUMBER YES COMMITTEE? [] NO 6.NAME for Primariwhich OF OFFICEHOLDER thislYco"'mi"oo Formed o.iS primarily CANDIDATE Committee ~o~od. OFFICE LIstnarnes SOUGHT ofo~ceholder(s) OR HELD or[][] candidate(s) OPPOSE SUPPORT <br /> NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD <br /> COMMITTEEADDRESS 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 /> Attach 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 informati~mntained herein and in the attached schedules <br /> is true and complete. I certifyunder penalty of perjury under the laws. ) <br /> of the S to of California that the foregoing is truend correct. <br /> <br /> Executed on .~ ~'~ By <br /> ~' OATHI s~GNATURE~Fc~N~R~LL~NG~FF~CEH~LDERCAND~DATE~STATEMEASUREPR~P~NEN~RRESP~N$~BLE~FF~CER~FSP~NS~R <br /> Executed on By. <br /> DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CAN~]IOATE, STATE MEASURE PROPONENT <br /> <br /> Executed on By. <br /> OATH SIGNATURE OF CONTROLLING OFFICEHOLOER, CANDIDATE. STATE MEASURE PROPONENT <br /> <br /> FPPC Form 460 (8/99) <br /> For Technical Assistance: 9161:~22-5660 <br /> State of California <br /> <br /> <br />