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Type or print in ink. COVER PAGE * PART 2 <br />Recipient Committee <br />Campaign Statement <br />Cover Page- Part 2 ~ <br /> Page ~'~ of 9 <br /> <br />4. Officeholder or Candidate Controlled Committee 5. BallOt Measure Committee <br /> NAME OF~O~FICEHOLDER OR CANDIDA~T~ NAME OF BALLOT MEASURE <br /> <br /> RE ZiP Identify the conbolling officeholder, candidate, or state measure proponent, if any. <br /> <br /> Related Committees Not Included in this Statement: ,Is~ any committees <br /> not Included in this consolidated statement that are controlled by you or which are primarily OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY <br /> formed to receive contributions or to make expenditures on behalf of your candidacy. <br /> <br /> CO~Mn-r~E NAME ,.D. ~U~ER 6. Primarily Formed Committee ,,t n,m, of officeholder(s) or candidate(s) <br /> for which this committee is primarily formed. <br /> <br /> NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT <br /> NAME OF TREASURER CONTROLLED COMMI*r-rEE? ~-----~ [] OPPOSE <br /> ~ ' [] YES [] NO <br /> COMMI~IcE ADDRESS STREET ADDRESS (NO P.O. BOX) NAME OF OFFICEHOLDER__ OR CANDIDATE !OFFICE SOUGHT OR HELD [] SUPPORT <br /> r [] OPPOSE <br /> <br /> CITY STATE ZI?~__~E AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [] SUPPORT <br /> ~ [] OPPOSE <br /> <br /> Attach con#nuation sheets if necessaty <br />7. Verification <br /> I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules <br /> is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. <br /> Executed on ' ~/'~'~?/~ By' <br /> <br /> x,cutedon ' By <br /> ' DATE SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE, STATE MEASURE PROPONENT OR RESPONSIBLE OFFICER OF SPONSOR <br /> <br /> Executed on By <br /> DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT <br /> <br /> Executed on By <br /> DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT <br /> <br /> FPPC Form 460 (8/99) <br /> For Technical Assistance: 916/322-5660 <br /> State of California <br /> <br /> <br />