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Officeholder, Candidate, Type or print in ink. COVER PAGE-lONG FORM <br />and Controlled Committee Statement covers period Date Stamp <br />Campaign Statement -- LongForm from/P~ <br />(Government Code Secbons 84200-84216.5) <br />SEE INSTRUCTIONS ON REVERSE through [~ ~ I~ D ~ ~ I of <br />Check one of the following boxes to Indicate the type of statement being filed: Date of election if applicable: For Official Use Only <br /> B Pre-election Statement (Month, O,y,Y,,,) AUG 2 9 ~ <br /> Supplemental Pre-election Statement (Attach a completed Form 495 to this statement.) <br /> ~ Special Odd-Year Campaign Report /7/ ~ <br /> Semi-annual Statement // ~' CITY OF REDWOOD QTY <br /> Termination Statement (Attach a completed Form al Sto this statement.) ~lleTY~ <br /> Officeholder. Candidate, and Controlled Committee II Other Committees ot Inclu his Stateiment: <br /> Included in this Statement committees not included in this consolidated statement that ere controlled by you and any <br /> NAME O~ ~OFFICE HOL~E~E/R~ OR CANDII~ATE committees of which you have knowledge that are primarily formed to recelve contr <br /> or to make expenditures on behaff of your candidacy. <br /> . /~/~*c /~/~~/~ i CO~M.,,,.AM, !,~ <br /> OFf ICE SOUGh1 OR I~E LD (INCLUDE LOCATION ANiO DISTRICT NUMBER If APPLICABLE) <br /> <br /> RE $1DENI~AL OR IUSINESS ADDRESS ~ ~NO AND STREET) (- J ~ NAME Of 1REASURER CONIROLLED COMMITIEE <br /> <br /> CI,¥ ID / i ~ ~ ~EATE ~ .4 ~ ~C(~..~D~.., AREA COOEfOAYTIME PHONE COMMITTEE ADORESS ,.0 ANO STR[[~I') <br /> <br /> COIMMITTEE NAME I ~-./ / ( ,~/~ ~,~/ [ ID. NUMBER CITY SIAIE ZIPCODE AREACODE~DA¥11M[ PHONE <br /> I <br /> COMMITTEE NAME ~ ~ O NUMBER <br /> , C OMMI~T /~.~[ <br /> I <br /> c"' i' C, . ...,o,,,,._. <br /> NAME OF ~EASURER [ // C~M~E[ ADD.SS lNG <br /> PERMANEm ST~ET) [ CnY STATE ZIP CODE AREA COO[~AYTIME <br /> <br /> CITY ~ ~ j / S~TE ZIP CO~ A~A CODE~AYTIME PH~E <br /> <br />III VerificatiOn <br /> I have u~ed all reachable diligence In areparing this statement. I have reviewed the statement and m th~f m~know~mation contained herein and in the aUached schedules <br /> i true and complete. I~e~if~under ~nll~ of ~jury pnder the~aws of ~e State of California that the for~s t~or~e~. ~ <br /> <br /> OAf~ ' ' ~'TY ANO~T~TE ' ~ ' -- SIGNATURE Of TREASURER <br /> An ofliceho~er m undidate who controls a comm~ee must also verify the campaign statement, I have use~ ~11 reasonable diligence and to the ~st of my~owledge the treasurer has used all <br /> reasonable diligence in pre.ring this ~atement, I have reviewed the statement and to the ~ of my kn~ledge the information contained herein and in t~ a~ached schedules ~s true and <br /> complete, I ce~ify un~er ~nalty of ~rju~ under th~ laws of the State pi California that the foregoing ~d co~./ ~ / <br /> <br /> E,ecuted on At By / <br /> DAlE CiTY AND STA~E SIGNATURE O~ CANDIDAIE/OfFICEHOiDER <br /> <br /> E~ecuted on At By <br /> DAT~ CITY AND ~TATE SIGNATURE Of CANDIDATE/OFFICEHOtO(R <br /> <br /> <br />