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Officeholder, Candidate, Typeor print in ink. COVER PA(~E - LONG FORM <br />and Controlled Committee Statement covers period Date Stamp <br />Campaign Statement Long Form ,.o. ~'"- ' ~ ,~,~ ~ ~ ':'" <br />(Government C~e S~ions 842~-M2165) ', .~, <br />SEE INSTRUCTIONS ON REVERSE <br />C~ck~t~fo~~xestoi~kitet~stitement~l~fl~: Dite~eb~Hip~: AU612 ::>A ,w ~-- <br /> <br /> Supplemental Pre~l~mn Statement (A~ach a completed Form 495 to this statement.) <br /> <br /> Semi-annual S~tement <br /> Termination Statement (A~ach e complet~ F~m 41S to this ~atement.) <br />I OfficeholdecCandidat&, and Controlled Commi~ee II Other Committees Not Included in this Statement: ~,~o~ <br /> Included in this S~tement c~m~ees <br /> NAM~ <br /> OF <br /> OFF~E~ER <br /> OR <br /> <br /> I <br /> ~J~J ~ ils ~SS ~. A~ ST~ il ~ lJJl CJ~LED C~M~lll <br /> <br /> ~ % STATE ~ C~ ~ C~A~E ~ C~EE A~SS ~. ~ S~ <br /> <br /> . . ~..-. " , . ' /~ -,,,'~ I [I).N~m '" <br /> COMMI~EE WE <br /> STA~ <br /> C~ <br /> C~A~NE <br /> <br /> I <br /> ' ~" ' '" ' ' ' ~MT~ C~RmLEDC~M~E? <br /> STATE ~ C~ W C~YTME ~ <br /> <br /> NAME OF TRE~URER c~ ~s~ <br /> <br /> ~ ' rllAll ~J A~ACJA~Jl~ <br /> <br /> complete. I ceRi~ u~er ~na~ of ~rju~ under the laws of the State of California that ~e foregoing is true and ~orr~ <br /> . . ~.~.~ . ~-,,:.'.-".:'~_ ~: _ . .~.~ ./ ?.=,~ <br /> <br /> ' ,- DATE ~Y AND STATf ~ ~.~-::x SIGNATURE ~NDIDA~EI~F~I~D~ <br /> Executed on At By <br /> DATE C.Y AND STATE SIGNATURE OF ~NDIDATE~F~[H~DER <br /> <br /> Executed on At By <br /> DATE C~Y AND STATE SIGNATURE ~ CANDIDATE~F~EH~DER <br /> <br /> FOR INF~MAT~ ~I~D 10 BE ~OVI~D TO Y~ PU~UA~ TO THE INFORMAT~ P~ES A~ ~ Ig77, SEE fNFO~AllON MA~AL ~ ~MPAIGN DISCLQSURE PR~VISIONS OF THE POLmCAL REFO~ <br /> <br /> <br />