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Type or print in ink. COVER PAGE - PART 2 <br />Recipient Committee <br />Campaign Statement <br />Cover Page m Part 2 <br /> Page ,~_ <br /> <br />4. Officeholder or Candidate Controlled Committee 5. Ballot Measure Committee <br /> NAME OF OFE[C. EHOLDER OR.CANDIDATE NAME OF BALLOT MEASURE <br /> <br /> OFFICE ~UGHT OR HELD (INCL.UDE LOCATION AND~DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LE'FTER [ JURISDICTION [] SUPPORT <br /> /ff~X~t~' &~ ~a~/~a~l ~1;'~/~ ~ , [] oPPOSE <br /> <br /> RESIDENTIAL/BUSINESS ADDRESS (NO. AND ,~TREE~T) CiTY STATE ZIP Identify the controlling officeholder, candidate, or state measure proponent~ if any. <br /> ' ~/~ /qJ~/C~? ~ ~~ NAME OF OFF,CE.OLDER. CAND,DATEOR. PROPONENT <br /> <br /> Related Committees Not Included in this Statement: List 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 /> COMMITTEE NAME I.D. NUMBER 6. Primarily Formed Committee List names of officeholder(s) or candidate(s) <br /> I ~t~ for which this committee is primarily formed. <br /> <br /> NAME OF OFFICEHOLDER OR CANDIDATE ~ OFF~E SOUGHT OR HELD <br /> COMMI~EE ADDRESS STREET ADDRESS (NO P.O. BOX) ~ ~ ~ ~ SUPPORT <br /> <br /> CI~ ~ ~ STATE ZIP CODE AREA COD~PHONE NA~E O OFFICE E CANDIDATE OFFICE SOUGHT OR HELD <br /> <br /> Attach continuation sheets ff necessa~ <br />7. Verification <br /> <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 aRached schedules <br /> is true and complete. I ce~i~ under penal~ of perju~ under the laws of the State of~ifornia that the foregoing is true and correct. <br /> <br /> Execut~ on ~ By <br /> <br /> [xocut~ <br /> By <br /> ~ GNAT(~E~: CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT <br /> DATE SI <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 />