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Officeholder, Candidate, <br />and Controlled Committee <br /> Stetem.ent coyers period Date Stamp <br /> <br />Campaign Statement -- Long Form ,,o~ /~/~ <br /> <br /> ~ck ~ ~ t~ fo~l~ ~es to i~k, te the ty~ of Itateme~t ~lng flied: D~te ~ all,ton ff applka~: <br /> <br /> Supplemental Pre-albion Statement ~ach ~ completed Form 49~ to this star,meat ) ~ ~ <br /> <br />!, Officeholder. candidate, and Controlled committee ......... Jl O~h~r Committees i 'Or J~cluded in this statemeht:' <br /> '~AME Of O~EHOLDER ~ ~N~ATE c~m~ee~ or.ich you he~ k~e~e ~et a~ p~arl~ ~ed to recef~ ;~trib~t~ <br /> m tO m~ke ex~es on ~ff ~r c <br /> <br /> ~ C~M~EE AD~ ~ AND ~1RIET) <br /> i <br /> C~ ST~IE Z~ CODE ~A C~g~AYTIME ~E ~Mg ~ ~E~U~ CO~OLLEO <br /> <br /> NAME OF.TRE~U~ER ~ c~u~(~ ~¢S t~o, ,~o ~t) . <br /> <br />Iii verification <br /> i have U~d itl tea~ebte diligence tn preparing this statement. I have reviewed the statement and to the ~ ~ my ~led~mat~on contained herein e~ <br /> i true end ;~1~ U~er ~ of ~rjur~n~ the laws of t~ S~te of California that the foregom~ is tru~and ~;e~. ~ <br /> <br /> An Mf~ho~r ma~Mlte w~ (~ttolf e commlffee mu~ illo verify t~ campaign f~temlnt I have used all tea~nable dilige~e end to the ~ of my knowledge the treasurer has used all <br /> reasonable d~lige~e in pTe~i~ this ~ateme~. I have rewewed the statem eat and to the ~st of m~ kn~ledge the information contained he, em and in the a~ached sc.hedufe1 is true and <br /> complete.Executed pal ce~i~//~/ueder 'J~naffY. ~..of ~qurYAt under lhe~ (.~oa-/laws of the~ S~te~t ~°f Californialhat/~ the foregomg is trUegy and cot~O,/~/ ~/~~~ ~ <br /> Execut~ o~ ~t By __ · <br /> Executed on At By <br /> <br /> <br />