Claire 07-01-1999 thru 09-18-1999 Special 490

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Officeholder, Candidate, ,ype m print in ink. COVER PAGE- LONG FORM and Controlled Committee Statement covers period Date Stamp Campaign Statement -- Long Form f,o. SEE INSTRUCTIONS ON REVERSE through . '::='~ / I[ I Check one of the foNowing boxes to indicate the type of statement being filed: Date of electiofl if applka~le: Page .. of Pre-electron Statement (Month, De]f, Year) For Official Use Only Supplemental Pre-election Statement (Attach a completed Form 495 to this statement.) $ E P 2 ~ 1999 special Odd-Year Campaign Report Semi-annual Statement CiTY ©F RL ......._=. ~ I*Y Terminat~n Statement (Attach a completed Fcxm 415 to this statement.) CITY CLFRK L/St any other Im lis Statement c~n~m,s not Included in this consolidated statement that are controlled by yoo and any NAME Of OfFICEHOLDER OR CANDEMTE corem/fleas of which you have knowledge that ere primarily formed to Taco/va contrlbuttom COMMITTEE NAME OFFICE SOUGHT O4~ NEU) ~INCLUO( LOCATION AND DISTIMCT NUMIEI~e A/IFUr. AB~) I I~MDENTIAL O~ BUSINESS ADOIIESS / ' ~10, AND STIIEET) NAME OF TREASU~R CONTROtLED COMM/TTEE I[I Verification ' I. have used ell ?e_ so~. ble..dd~e, nco in I~.epe.ring .this statement. I have. reviewed the ~..a. tement end to the best of m/~ knowledge the Info, marion contained herein end in the attached schedules is [~ue~n~c~mpiete.~/cert~/~y~n~erpenaRy~pe?~J)uryunderthe~ws~th~stateofC~h~mi~thatthef~rK-is/tme~ndcQcTeCt~ .-..) DATE * CITY AND STATE - / - "-- - ' - CMGNATUI~ OF TREASU~R rA:a._o_tf_k_e~__m_~:_n_ _d~____t_e .who_cT .ont[.ds_ · comm..Ittea must els~. _.v~,if~..the cam. paig. n s~ta. ment.. I ha.ye us~l. ell re.espn. ?ble_di!igence.ind to the best of my knowledge the treasurer has used ,,~,~,a. um.u,,~..e.m.e ,.n la,pir[.ng [.nL~ r,~Temen, t. ! nave rev?wee rna staTemenT encl to me oest OT my KnOWleDge the in~)r~fa~tjOn cc)~tai)alcl h4t[eir, l.4nd in the Ittlch~ schedules is true and corollate. , cemTy un~e~ I)ena~ OT perjury une~ the laws of th4~ State of~C~alifOFnie that the foregoing is true end ~ / /// // CIT~/AND STATE SIGNATUI~ OF CANDIDATE/OfflCEHOLI~R Executed on. At By DATE CITY AND STALE SIGNATURE OF CANOIOATEi~fflCEHOtD(I~ Executed on At By DAlE cn*Y ANO STATE SIGNATU~ OF FC~ INi~OaMATION ~Q4JI~D 10 B~ I~OVIO~D TO YOU PURSUANT IO Tl~ iNfORMATION PeACTICES ACI OF 1S77, SEE IN~ORMAIION MANUAL ON CAMPAIGN plSCLOSURE PROVISION~ C)f I~ Pt~4.nlCAI~ I~ f.n~.__u.