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COVER FAGE <br />""-" 'r~ec~p~emCommittee Type or print in ink, _ pete S~;;T~ -- , <br />Campaign Statement ,~ r ,¢/ ~, <br /> <br />(Government Code Sections 84200-84216.5) Il\" <br /> Statement cove/rs period Date of election if applicable: JUL 3 i Z00Z <br /> from ~ /OX ! '~(:~3~ (Month, Day, Year) ~lCtTY OF ~EOW000 C~ '~ge~ of~ <br /> SEE INSTRUCTIONS ON REVERSE throughXX[~X ] ~ X C~TY 0~[R~ ~ ~r ~i~. Only <br /> <br /> 1. Type of Recipient Commiffee: All Commi~ees - Complete Parts t, 2, ~, and 4. 2, Type of Statement: <br /> holder,Candidate Controlled Comm~ee ~ Ballot Measure ~mm~ ~ Pr~l~tion Statement <br /> Qua~edy <br /> Sbtement <br /> S~te Candidate Ele~ion CommiEee O Pfimadfy F~ ~emi-annual S~tement <br /> ~ S~cial Odd-Year RepoA <br /> O Re~ll O ~ntmlled ~ Te~inatDn S~tement ~ Su~lemenbl P~le~ion <br /> (~Pa~5) O Sponsored <br /> ~Amendment (Explain below) Sbtement - A~ach Fo~ 495 <br /> ~ General Pu~ ~mmi~ee <br /> O S~nsored ~ Pd~dly Fo~ Candidate <br /> O S~II ~n~butor ~m~ ~holder ~mmi~ee <br /> O Polit~l Pa~/Cen~l ~mmi~ee ¢1~ ~¢~ ~ ~ <br /> <br />3. Committee Information ~ , D NUMBER ~~ <br /> Treasure,s) <br /> COMMI~EE NAME (OR CANDIDATE'S NAME IF NO COMMI~EE) NAME OF TREASURER <br /> <br /> Cl~ " STATE ZIP CODE <br /> <br /> Cl~ STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF A~ <br /> <br /> MAILING ADDRESS (IF DIFFERENT} NO AND STREET OR Re. BOX MAILING ADDRESS <br /> <br /> Cl~ STA~ ZIP CODE AREA CODE/PHONE CI~ STATE ZIP CODE AREA CODE/PHONE <br /> OPTIONAL: F~ / E-MAIL ADDRESS OPTIONAL: F~ / E-MAIL ADDRESS <br /> <br />4. Verification <br />I have used all reasonable diligence in preparing and reviewing this statement and to thee best of my knowledge the information contained herein and in the attached schedules is true and complete. I <br />certify under penalty of perjury under the laws of the State of California that the foreg~ng is true and co*-rect. <br /> Executed on ,~ / '~'~ I ~t~~'~ S Y ~ure of Trea~rer or Assistant Tz ....... <br /> <br /> <br />