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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 /> <br />4. Officeholder or Candidate Controlled Committee 5. Ballot Measure Committee <br /> NAME OF OFF?~I~. HOLDER ~IR CANDIDATE NAME OF BALLOT MEASURE <br /> <br /> ~ESIDE~IN~S ~D~ESS (N~. AND S~RE~) .CI~ STA~ ~P I~nt[~ the con~lling ~cehol~r, ~ndidate, or ~ate measure ~oponent, if any. <br /> <br /> Related Commiffees Not Includ~ in this Statement: <br /> not I~u~d !~ th~s co~solidated s~tem~ that are ~n~lled ~ ~ ~ whi~ a~ ~marl~ OFFICE SOUGHT OR HE~ DISTRICT NO. IF ~Y <br /> f~ to re~e ~n~ibutlons otto make ex~ditums on ~a~ of y~r candidacy. <br /> <br /> COMMI~EE N~E ~I.D. NUMBER 6. Primarily Formed Committee u~.~mes ofoffic~der(s) ~ ~ndidaf~s) <br /> <br /> N~E OF OFFICEH~DER OR CANDIDATE ~ ~FFICE SOUG~ OR ~ELD <br /> <br /> N~ OF OFF~CEhOL~r OR C~D~DATE I~E ~OUG~ OR HELD ~S~PORT <br /> ~MI~EEADDRESS / STREET ADDRESS (NO P.O. BOX) <br /> <br /> A~a~ ~n~nuation s~ts ff nece~a~ <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 ~ntained herein and in the a~ched s~edules <br /> is true and ~mplete. , ced~ under pena,~ of ~rju~ under the laws of ~e State of Cali~ia~egoing is t~e and correct. <br /> <br /> ~TE /{/ I ~~ OF TR~URER 0 R ASSISTA~ TR~URER <br /> <br /> Ex~ut~ ~ ............... By. <br /> S~ OF ~RO~ OFF~EHOLDER, ~DIDA~, STA~ M~RE P~P~ENT <br /> <br /> ~t~ ~ By <br /> SIG~TURE OF ~RO~ING OFFI~HOLD~ C~DATE, STA~ ME~URE PROPONENT <br /> <br /> FPPC Fo~ 490 (8~9) <br /> F~ T~nical ~sis~n~: 9t6/322-56~ <br /> State of Calif~ia <br /> <br /> <br />