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officeholder, Candidate, ,ype of print in ink. COVER PAGE-LONG FORM <br /> Statement covers period Date Stem p <br />and Controlled Committee . <br />Campaign Statement Long Form f,o. TM.... <br />(Government Code Sections 84200-84216.5) through ~:~ ~) - ~' i'i i~&ge / of''~ .- <br />SEE INSTRUCTIONS ON REVERSE : ~ <br />Check one of the following boxes to indiclte the type of statement being f;l~': Dlteofele~IoniflpplJca--h~--: i~ JUL 2 6 ~95 !) ~ For Official Use Only <br /> (Month, Day, Year) <br /> p Pre-election Statement ~ <br /> Supplemental Pre-election Statement (Attach a completed Form 495 to this statement.) ~ <br /> I-] Special Odd-Year Campaign Report L~~ <br /> * RE~,WO~D CiTY <br /> <br /> [] Semi-annual Statement ' <br /> I"~ ~ ~s statement.) ---. : <br /> 1--~fl m ate_an ontro · ommlttee committees not included in this comolidated statement thet ere controlled by you and any <br /> Inc is Statement comm/ttees of which you have knowledge that are pr/mar//y formed to receive contr/but/om <br /> NAME OF OFFICEHOLDER OR CANDIDATE or to make expenditures on beheff of ~/our candidacy. <br /> j.~ ~2~ ,/q)~ LJR ~ CoMMnTE, NAME <br /> <br /> CONTROLLED COMMITrEEI <br /> ~SmEm~.O~USMSSAOOaSS (NO. AND~*i~ I--I xes I-I No <br /> <br /> - STATE ZIP CODE AP~K Cu~./DAYTIME PflONE COMM~'TTE~ ADDRE$~ <br /> ~ I.D. NLI~B~-~ ~ STATE ZIP ~.~ AREA CODE/DAyTIME PHONE <br /> <br /> I I.D. NUMBER <br /> <br /> COMMITTEE ADDRESS (~,. (NO. AND STREET) <br /> CONTROLLED <br /> <br /> ' · - STATE ZIPCODE AREACODE/OAYTIME -pta~---! [] 'YES [] No <br /> <br /> ~ CoMMnl'EE ADDRESS (NO. AND STREET) <br /> N~ME OF TREASURER , <br /> ?~0--~ ~' ~ d~/~ ARE~ COOE/OAYTIME PHONE <br /> I~RMANENT ADDRESS Of TREASUI~R ~ (NO. AND STREET) CITY STATE ZIF' CODE <br /> <br /> cnY STATE ZffI) CODE AREA COOE/DAYTIME PHONE <br /> A~lch ~dd/doMI Informer/on on epjcN'opriate/y lebe/ed cont/nuetion sheets. <br /> <br /> nable dill ence'in preparing this statement. I have reviewed the statement and to the best of my ~i~edAe the,~forej~tiog,egn~1~d herein end in the attached schedules is <br /> I have u.sed all .reaso. _-- g ................ ...,~. ,......~f the Stat. of California that the foregoing is ~.j&ifid.e6rrect.//~ ~/ <br /> trueandcom late I rTiwunoerpeni~yu~l~e~u-u~,---,~-4,Y <br /> <br /> Executed on ~7/:~,,/r-//C~ . At / ) c~ - ~ - . ~N~TURE Of T <br /> ~ O&TE ' CITY AND STATE <br /> An officeholder M clndldete who controls a committee must also verify the campaign statement. I have used ell reasonable diligence and to the best of my knowledge the treasurer has used all <br /> reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my knowledge the information contained herein and in the attached schedules is true and <br /> complete. I certif~ under penalty of perjury under the laws of the State of (:aJifornia that the foregoing is true~lnd correct. <br /> Executed on 7/~--~/~'' At <br /> . '/V/ /j - SIGNATURE of CANDIDATE/O,~EHOtofa <br /> (, ¢ DATE CITY AND STATE <br /> <br /> Executed on At By <br /> DATE CITY AND STATE SIGNATURE Of CANDiDATE/OFFICEHOLDER <br /> Executed on At By <br /> DATE CITY AND STATE SIGNATURE OF CANDiDATE/OfFICEHOLDER <br /> FnR ~NFC)~MATION REQUIRED TO BE PROVIDED TO YOU PURSUANT TO THE ~NFORMATION PRACTICES ACT of !g77, SEE INFORIdATt0N MAN~)AL 4~)N CAMPAIGN DISCLOSURE PROViSiONS Of THE POLflqCAL REFORM ACT. <br /> 4',~,~ ~ f'slffr~rni:l F~lr Pnliti¢~l P~actices Commission <br /> <br /> <br />