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Type or print in ink. COVER PAGE - I~ART 2 <br />Recipient Committee <br />Campaign Statement <br />Cover Page- Part 2 <br /> <br />4. Officeholder or Candidate Controlled Committee 5. Ballot Measure Committee <br /> <br /> NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE <br /> <br /> RESlDE~IA~USlNESS ADDRESS (NO. AND STREE~ C~ STATE ZiP Idenfi~ ~e con,oiling officeholder, candidate, or s~te measure proponen~ if any. <br /> ~[~00~ Ct~ C ~ ~U04~ NAMEOFOFFICEHO~ER, CANDIDATE, ORPROPONENT <br /> <br /> Related Commi~ees Not Included in this Statement: <br /> not included In this consolidated sta temen t 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 candidac~ <br /> <br /> C~MI~EE ~ME LD. NUMBER 6, Primarily Formed Commi~ee List names of officeholder(s) or candidate(s) <br /> for which this comml~ee Is prlmadly formed. <br /> <br /> NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ~ SUPPORT <br /> NAME ~TREASURER CONTR~D COMMI~EE? ~ OPPOSE <br /> ~ YES ~ NO <br /> C~MI~EE ADDRESS STREET ADDRESS (NO P.O. BO~ NAME OF OFFICEHOLDER OR CANDIDATE O~ICE SOUGHT OR HE~ ~ SUPPORT <br /> ~ OPPOSE <br /> <br /> C~ STATE ZIP CODE AREA COD~HONE NAME OF OFFICEHOLDER OR CANDIDATE O~ICE SOUGHT OR HE~ ~ SUPPO~ <br /> ~ OPPOSE <br /> <br /> A~ach continua~on sheets if necessa~ <br />7. Verification <br /> t have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules <br /> is true and complete. I ced/fy under penal~ of perju~ under the laws of the State of Cal~ornia that the foregoing is true and correct. <br /> <br /> Ex~utedon ~~ ~/. ~ By <br /> <br /> ~ecutedon ~'- - ~"DA~?/ ~ ~ By ~GNA~RE~FC~NTR~L~NG~FF~cEH~LDER'CAND~DATE'STA~M~URE~P~NENT~RRE8P~NS~BLE~FF~CER~FSP~NS~R <br /> <br /> ~ecut~ on. By <br /> SIGNA~RE OF CONTROLLING OFFICEHOLDER, C~DIDA~, STA~ MEASURE PROPONENT <br /> <br /> ~uted on By <br /> DATE 818~RE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT <br /> <br /> FPPC Form 460 (8/99) <br /> For Technical Assistance: 916/322-5660 <br /> State of California <br /> <br /> <br />