Laserfiche WebLink
'Officeholder, Candidate, Type o, print inink. COVER PAGE- LONG FORM <br /> <br /> (Government C~e S~ions 842~-84216 5) <br /> SEEINSTRUCTIONSONREVERSE thr .~ ; ~ ~ ~ <br /> Supplemen~l Pre~ion S~tement CA.ach a completed Form 495 to this statement.) <br /> ~ S~ial ~d-Year Cam~ign Re~ <br /> ~ Semi-annual Statement <br /> ~ Terminat~nStateme~t(A~ach.completedForma1Stothisstatement.) -- ~l ~~l <br />I, ~fficeholder. Candidate, and Controlled Commi~ee II Other Commi~ees~ot Inciu~e~ tn this Statement: u~,~ <br />In cl u d ed i n th is State me nt c~ees ~ i~l~ in t~ ~t~ natant that are c~l~ by you a~ any <br />NAME O~F~EH~D~ ~N~ATE ;~es of ~h y~ ~ k~ t~t a~ ~tmarl~ f~m~ ~o r~e~ c~tri~l~ <br /> <br /> I <br /> <br /> COMMI~EE ~E <br /> I <br /> ~ME ~F TRE~U~ R c~ ~ss ~. ~ s~ <br /> <br />III Verifi~flon <br /> I h.. u~ all re.~a~ dil~e~e in pep.ring thil statement. I have revi~ the Aatement a nd tO the ~A of my k n~ the infor~tain~erein a~ in the ..ached Ich~ u~ <br /> I tr~ a~ C~ ~,~ u~ of ~u~ under the la~ of ~ S~te of ~li~o$nii that the for~oi~ is true and~or~. ' ~ ~ <br /> <br /> An ~e~; ~ ~te w~ ;~tr~; · ~omm~ee mu~ a)~o ver~ t~ ;am~n ;~teme~. I have u$~ ~11 rea~le diligence ~he ~t of m~ ~w edge the treasurer h~ used <br /> reasonable dilige~e in pre.ring thi~ ;tatement, I he~ reviewed the statement and to the ~ of my kn~l~ the i~fo~t ~n (o~ain~ere n an~ ~a(hed ~hedule~ is t;ue and <br /> complete. I ce~i~ un~ ~n~y of ~rju~ under the laws of the State of Californie that the foregoing is true I~ c~r~ ) : /j // · <br /> <br /> Ex~uted on. At By <br /> <br /> <br />