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Officeholder, Candidate, COVER PAGE - LONG FORM <br />and Controlled Committee Type or print in ink. Statement covers period Dale Slump CALIFORNIA ~.C~ <br />Campaign Statement- Long Form from t// t / ~ ~ ~ ~ ,4 FORM <br />(Government Code Sections 84200-84216.5) / 4/ <br />SEE INSTRUCTIONS ON REVERSE through q / ¢¢ ; / of / <br />Check one of the following boxes to indicate the type of statement being filed: Date of election if applicable: SIP 2 3 1{~99 --or Official Use Only <br /> [~ Pre-election Statement (Month, Day, Year) <br /> [] Supplemental Pre-election Statement (Attach a completed Form 495 to this statement.) <br /> [] Special Odd-Year Campaign Report <br /> [] Semi-annual Statement / I/0 Z / ¢ e OF <br /> [] Termination Statement (Attach a completed Form 415 to this statement.) ' CiTY CL..E.?~K~.. <br /> <br />I Officeholder, Candidate, and Controlled Committee II Other Committees Not Included in this Statement: List any other <br /> I ncl u dad i n this Statement committees not included in this consolidated statement that are controlled by you and <br /> NAME OF OFFICEHOLDER OR CANDIDATE any committees of which you have knowledge that are prfmarily formed to receive <br /> LA VE~t~/~ A~T¢-~ E]~ L y contrfbutionsortomakeexpendituresonbehalfofyourcandidacy. <br /> <br /> OFFICE SOUGHT OR HELD (INCLUDELOCATION AND DISTRICT NUMBER IF APPLICABLE) COMMITTEE NAME II.D. NUMBER <br /> <br /> I <br /> R DD i'NO. STREET) NAME OF TREASURER CONTROLLED COMMITTEE? <br /> <br /> STATE ZIP CODE AREA CODE/DAYTIME PHONE COMMITTEE ADDRESS (NO. ANDSTREET) <br /> CITY_ <br /> <br /> COMMITTEE NAME I.D. NUMBER CITY STATE ZIP CODE AREA CODE/DAYTIME PHONE <br /> o F Z IC7' / ¢0---/ COMM,TTEE.AME ' ,.O..UMBER <br /> COMMITTEE ADDRESS(NO. AND STREET) <br /> 51~ CRItVCt£ DF~IVE <br /> NAME OF TREASURER CONTROLLED COMMITTEE? <br /> CITY STATE ZIP CODE AREA CODE/DAYTIME PHONE <br /> ~l~Dl~0o~ crT), CA qz/odS- ¢¢ CIYES E].o <br /> COMMITTEE ADORESS (NO. AND STREET) <br /> NAME OF TREASURER <br />' ~4 Z/¢'~'~'-(-- ,z~ 7-~ C~z LV C,TY STATE Z,P COOL AREA CODE/OAYT,ME PHONE <br /> PERMANENT STREET) <br /> <br /> CITY STATE ZIP CODE AREA CODE/DAYTIME PHONE Altech additional information on approp#ately labeled continuation sheets. <br /> <br /> I' <br />III Verification <br /> I have used all reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my k[~dgethe information contained here~j~and in the attached schedules is true and <br /> complete. I certify under penalty of perjury undo' the laws of the State of.,~a [or. ia that the forego ng s true and correct./ · <br /> Executedon ~----/-~3)--,~ At /~--~"-~ (--~/~", ~ By ~/.~ c~t.~.,,~_.~ <br /> · DATE ' CITY AND STATE ~ ' ' SIGNATURE OF TREASURER (-.- <br /> / <br /> An officeholder or candidate who controls a committee must also verify the campaign statementl have used all reasonable diligence and to the best of my knowle(~ge the treasurer has used all <br /> reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my knowledge thej,,~ormationcontained herein and in th,e'~ttached sche~lules is true and complete. I certify <br /> under penalty of perjury under the laws of the State of California that the fo[egIing is true and, correct. /~,/ ., <br /> Executed on ~'~ ~ I~Ai~E- ~ At t~ ~ZD STAI~ ' ~ By ~ ~~NATUR~OER <br /> Executed on At By <br /> DATE CITY AND STATE SIGNATURE OF CANDIDATE/OFFICEHOLDER <br /> <br /> Executed on At By <br /> DATE CITY AND STATE SIGNATURE OF CANDIDATE/OFFICEHOLDER <br /> <br /> FOR INFORMATION REQUIRED TO BE PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT OF 1977, SEE INFORMATION MANUAL ON CAMPAIGN DISCLOSURE PROVISIONS~OF THE[ PO I~C_AL _REFORM ACT. <br /> State of California Fair Political Practices Commission <br /> <br /> <br />