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LONG FORM <br />Officeholder, Candidate, Type or Print i, Ink. Statemant covar~ <br />and Controlled Committee [~ ~ ~ ~ <br />Campaign Statement -- Long Form <br />(Govcmmcnt Code Scctions 84200-84216.5) <br />SEE INSTRUCTIONS ON REVERSE Ihrough. JAN 3 I 1992 <br /> C~ck o~ el t~ followi~ boxes to indicate t~ type el 8tatemenl being filed: · of Election ~ A F~ Olhciai Use Only <br /> ~ Pre-elecl~ Sla~t il npplioable: ~ OF REDWOOD Q[Y <br /> ~ ~pple~ntal Pre-elecl~ Stalem~l (Alta~ a ~mpleled Form 495 Io Ihis statement.) [Monlh, Day, Year) Cl~ CLERK <br /> ~ ~mi-~ual Stal~enl <br /> ~ Term~a~n Slal~enl (~lach a c~plel~ ~rm 4151o Ihis slal~enl.) <br /> <br />I Oflice~lder, Candidate, I1' Other Committees Not Included in this State~nt: Lis~ ~ o~her <br />and Controlled Co~ittee c~ittees ~t i~i~ed ~ th~ c~olidated state~ t~t are co~roiled by you a~ ~y <br />Included in this State~nt c~ittees of which you ~ve ~ledge that are pri~ily f~d to receive co~ributio~ or <br />~ ~ ~F~ ~ C~E: to ~ ~e~iture~ on be~ofyour ca~ida~. <br /> <br /> ~F~ ~ ~ ~: (I~L~ L~T~ ~ ~ST~I ~A F <br /> ~NT~~: (~ ~S1~) ~T~S~ER: C~IROIIEDC~TIEE? <br /> <br /> CI~ STATE Z~ ~ ~ C~ ~ C~ITIEE ~E~: (~ ~ <br /> ~~.~t~~ ~ ~ ~ ~l~-i,o~r C TY state <br /> <br /> ~TY STAT~ Z~ ~ ~ C~ ~e ~ ~ T~S~ER: C~TR~D C~EE? <br /> ~ ~ T~: ~ C~I~EE ~E~: (~ ~D ST~) <br /> <br /> ~NI ~ ~ l~ (~. ~ Sl~) CITY SLATE <br /> <br /> I] V.dliGllion Ofll~holder or Candld8l~: <br /> Trea~r~: I have u~ a] rc~nablc dili~cn~ ~d ~ ~c ~sl <br /> i ~ve ~ all r~nabic dilige~ in pining ~is sm~mcm ~d m ~ ~sl o[ my u~d ~! r~nablc diligence h prepping ~i~ smlcmcnl, i have rcvicw~ Ibc smm- <br /> ~w~c ~c ~[o~li~ conmi~d ~rcin ~d in ~ a~ch~ ~hcdul~ is ~ and mcnl ~d io Ibc ~sl of my knowledge Ibc info~ali~ contained herein <br /> c~p~. 1 ~fy under ~ly of ~rju~ under ~c laws or ~c Sm~ of C~ifomia al~d ~h~ulcs is ~c a~ complclc. I certify u~cr ~nally <br /> ~l L~ [~c~oing ~ ~ ~ ~ laws of ~ Stole of C~domia lhal Ibc foregoing is <br /> <br /> F~ ~F~II~ RE~IflED TO BE ~OVIDED TO Y~ ~SU~T TO TI IE INF~MATI~ PRACTICES ~T OF 1977. ~E I~MAI~~~ DISCI O~RE ~OVlS~ll 1[ ~lIl~ fl~[~M ACT <br /> Slale ol Calilornla Fair Political Praclices Commission. <br /> <br /> <br />