Steinfeld 01-01-1995 thu 12-31-1995 470

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Officeholder and Candidate Type or print in lni. SHORT FORM Campaign Statement -- Short Form [.~ [ (Government Code Section 84206) II (~ ~- Date Stamp [~ ~/~ For Officill Ut~ Only For use by officeholders and candidates who do not have a controlled committee and who do not anticipate receiving $1,000 or more in contributions and do not anticipate spending $1,000 or more during the calendar year. Officeholders whose salary is less than $100 per month and judges who have a controlled committee may use this form under certain circumstances. See the Information Manual on Campaiqn Disclosure Provisions of the Political Reform Act for Elected Officeholders, Candidates, and Their Controller~ Committ~;s for further information. I Statement Covers Calendar Year 19 II Officeholder or Candidate Information III Information on Office Sou~lht or Held NAME Of OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD RESIDENTIAL OR BUSINESS AI~DRE~S (NO. AND STREET) JURISDICTION (LOCATION) DISTRICT NUMBER CITY STATE ZIP CODE DATE OF ELECTION (MONTH, DAY, YEAR) (IF APPLICABLE) AREA CODE/DAYTIME PHONE NUMBER iV Committee Information List all committees of which you have knowledge that are primarily formed to receive contributions or to make expenditures on behalf of your candidacy. COMMITTEE NAME AND I.D. NUMBEfl COMMITTEE ADDRESS lU_AME OF TREASU~E~ V Verification I declare under penalty of perjury that to the best of my. knowledge, I anticipate that I will receive less than $1,000 and th I will s end less titan $1 000 durln the calendar year and that t have usc. dell ,.0.~.,,o~.,. u,,,v.,,.. ,,, p, epar,.g m~s statement. I certify under penalty of perjury under the laws of the State of California that/the foregoing is true and correct. FOR INFORMATION REQUIRED 10 Ii PROVIDEO TO YOU PURSUANT 1'O THE INFORMATIO~ PRACTICES ACT OF 1977. SEE INH~)RMATION MANUAL Old CAMPAIGN DIS(~ILO$1~I~ PROVISIONS OF THE POLITICAl. I~FdI~IRM Adl;'T.