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Cff;,;eholder, Candidate, COVER PAGE - LONG FORM <br />and ControlledCommittee Type or print in ink. Statement coversperiod! 490 <br />Campaign Statement - Long Form from ~L l; t°)~)~) ~~~=~ 1994 FORM <br />(Government Code Sections 84200-84216.5) <br />SEE INSTRUCTIONS ON REVERSE through <br />Checkoneofthefollowingboxestoindicatethetypeofstatementbeingfiled:~ Pre-election Statement ~o~~l~(Month, Day, Year) }~ ~ 2, 1999 ForOfficialUseOnly <br /> ~ Supplemental Pre-election Statement (Attach a completed Form 495 to this statement.) <br /> ~ Special Odd-Year Campaign Repeal ;Y C'7 r~D~'~C~OD CiT <br />  Semi-annual Statement CiTY <br /> Termination Statement (Attach a completed Form 415 to this statement.) <br />I Officeholder, Candidate, and Controlled Committee II Other Committees Not Included in this Statement: List any other <br /> I n cl u d ed i n th i s Statem ent commi~ees not included in this consofidated statement that are cont~lled by you and <br /> NAME OF OFFICEHOLDER OR CANDIDATE any commi~ees of which you have knowledge that are pdmadly fo~ed to ~ceive <br /> ~~ ~ . ~ ~~1' ~ ~ ~ cont~butions or to ~ake expenditures on behalf of your candidacy. <br /> COMMITTEE NAME ~ I.D. NUMBER <br /> OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IFAPPLICAeLE) <br /> <br /> RESIDENTIAL OR BUSINESS ADDRESS ~(NO. ANDSTREET) NAME OF TREASURER CONTROLLED COMMITTEE? <br /> <br /> CITY STATE ZIP CODE AREA CODE/DAYTIME PHONE COMMITTEE ADDRESS (NO, ANDSTREET) <br /> <br /> COMMITTEE NAME [ I.D. NUMBER CITY STATE ZIP CODE AREA CODE/DAYTIME PHONE <br /> <br /> COMMITTEE ADDRESS(NO. AND STREET) ] <br /> <br /> CIIY STATE ZIP CODE AREA CODE/DAYTIME PHONE ~ YES ~ NO <br /> <br /> COMMITTEE ADDRESS (NO. AND STREET) <br /> NAME OF TREASURER <br /> <br /> PERMANENT ADORESS OF TREASURER (NO. AND STREET) <br /> <br /> STATE ZIP CODE AR~EIDAYTIME PHONE A~a~ additional info.eBon on appmp~ately labeled ~n~nuaEon sheets. <br /> <br />III Verification <br />I have used all reasonable diligence in preparing this statement. I have reviewed ~e statement and to the best of my knowbdgethe information ~ntained~in and in the a~ached schedules is true and <br />complete. I cedi~ under penal~ of perju~ und~ the la~ of the State of Ca ~rn a that the forego ng s true and correct <br /> Executedon ~/ - ~ ~- t~ c At 1~.~~ ~ ~ ' By ~i' t/~.~, . ~ .1~ ~/ <br /> An officeholder or candidate who controls a committee must also verify th~ campaign statemenfl have us~ all reasonab~ diligence and to the best of my kno~edge the treasurer has used all <br /> reasonable diligence in preparing this statement. I have review~ the statement and to the best of my knowledge~f~atio~ed~r~nd in the a~ached schedules is ~ue a~ complete. I codify <br /> Executed~n~nd~rp~n~ty~fp~d~nd~rthe~aws~fth~tate~f~if~rniath~tth~g~ingistm~nd~rr~ct~~ ~: '~ At ~~ <br /> ~ DATE - CI~ AND STATE ' - -' ~ SIGNATURE OF CANDIDAT~OFFICEHOLDER <br /> <br /> Executed on. At By <br /> DATE CITY AND STATE SIGNATURE OF CANDIDATE~FFICEHOLDER <br /> <br /> Executed on At By <br /> DATE CITY AND STATE SIGNATURE OF CANDIDATE~FFICEHOLDER <br /> FOR INFORMATION REQUIRED TO BE PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT OF 1977, SEE iNFORMAtION MA~L ON CAMPAIGN DISCLOS~E P~VI~ONS OF THE PenCiL ~EFORM ACT, <br /> State of California Fair Political Practices Commission <br /> <br /> <br />