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Recipient Committee Type Or print in ink. COVER PAGE- PART 2 <br />Campaign Statement <br />Cover Page m Part 2 <br /> <br />4. Officeholder or Candidate Controlled Committee 5. Ballot Measure Committee <br /> NAME OF OFFI~,~, .HOLDER J31R CAND. IDATE . NAME OF BALLOT MEASURE <br /> <br /> ~Fj~E$}3UGHT~HEL~(~NcLUD[[L~ATi~AND~S~T~TN.L~1.~ER~FAPPL~CABLE)~{/~0~d ~'~ (~4/'/ ~:~/(C'h'~)J~ BALLOTNO. O" ~mE" i.,_o,cT,o, OPPosESUPPORT <br /> R. ESIDENTIAL/BUSINE, SS ADD~ESS {NJ~. AND STRE~'I') ~ClTY STATE ZIP Identify the controlling officeholder, candidate, or state measure proponent, ifany. <br /> <br /> Related Committees Not Included in this Statement: List any committees <br /> not lrtcluded In this consolidated sfatement that are controlled by you or which are primarily OFFICE SOUGHT OR HELD [ DISTRICT NO. IF ANY <br /> formed to receive contributions orte make expenditures on behelf of your candidacy, <br /> I <br /> COMMITTEE NAME I.D. NUMBER 6. Primarily Formed Camm ittee ust names of officeholder(s) or candidate(s) <br /> <br /> ~v~E OF OFFICEHOLDER OR C~DI~^TE I O~¢E SOUGHT OR HELD <br /> <br /> NAIVE OF OI:~:ICE[qOLD~R OR CANDIDATE I-OF,~E SOUGHt' OR HELD ~ ~ <br /> COMMITTEE ADDRESS ~ STREET ADDRESS (NO P.O. BOX) <br /> <br /> Attach continuation sheets/fnecessary / <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 Calif~q~ia ti~t~t~/foregoing is true and correct. <br /> <br /> DATE SIGNATURE OF CONTROLLIp OFF ~EHO f. DER, CANDI DATE. 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 490 (8199) <br /> For Technical Assistance: 9161322-5660 <br /> Stata of California <br /> <br /> <br />