Laserfiche WebLink
Type or print in ink. COVER PAGE - PART 2 <br />Recipient Committee <br />Campaign Statement <br />Cover Page m Part 2 <br /> <br />4. Officeholder or Candidate Controlled Committee 5. Ballot Measure Committee <br /> <br /> RESIDENT~J~BUSINESSADORI~S (Ne. AND'STREET)~ CI ,T~'. STATE ZiP Identlfythecenl~olllngefflceh~lder, candldata, orstatameasurepropo~ent, lfany. <br /> <br /> Related Committees Not Included in this Statement: List any committees <br /> <br /> COMMITTEENAME I.D. NUMBEE 6. Primarily Formed Committee <br /> [] YES [] NO [] OPPOSE <br /> <br /> A~ continuation sheets if necessan/ <br />7. Verification <br /> I have used all reasonable diligence in preparing and reviewthg this statement and to the best of my knowledge the info~Tnation co~tained herein and in the attached schedules <br /> is true and complete. I ¢erUfy under penalty of perjury under the laws of the State of Califomia that the foregoing is true and correct. <br /> <br /> Executed on ~ 0 J By <br /> Executed on By <br /> <br /> Executed on By <br /> [5ATE SIGNATURE CC CONTR~-UN(~ OFFICEHOLDER, CANmD^T~, STAT~ MEASURE PROPONE~r <br /> <br /> FPPC Form 460 (8/99) <br /> For Technical Assistance: 916/322-5668 <br /> State of California <br /> <br /> <br />