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Type or print in ink COVER PAOE- <br /> i�ecipient Committee <br /> Campaign Statement , ' � � � <br /> Cover Page— Part 2 � � <br /> 4. Officeholde� or Candidate Controlled Committee <br /> not Me/udw/n thls eonsoNdetsd rfeNm�nt thsten rnntrolled 6y you w whleh ns prlmeA/y <br /> /ormeo i,�reeNn conbi6uHon�or to m�M�rpnd/Nros on b�Ml/o/your esiM/deey. <br /> NAb:E <br /> CANTROLLED COMMffTEE4 <br /> ❑VES ❑ NO <br /> CITV , � �STATE ZIPCODE AREACO�FIPHONE <br /> Attaeh <br /> 7. Verification <br /> 5. Ballot Measure Committee <br /> NAMEOFBALLOTMEASURE <br /> [:�t�i51:� �.: a� : l�:�i:169i7�dli::l <br /> Pags_� of� <br /> LJ SUPPOR7 <br /> ❑OPPOSE <br /> Idsntlly Ihs eontrolling ofifeeholder.candidatq or sCSM messuro propo�snR N any. <br /> NAME OF OFFICEHOLDER,CMIOIDATE,OR PROPONEM <br /> IFANV <br /> s. PrimarityFormedCommittee Lbfnsrmro/ofl4e�ho/drr(s)wund/dsN(aJ <br /> M wAkh MN eommltM�Is prlm�illy Iormd. <br /> NAME OF OFFICEHOLDER OR CANDIDATE <br /> NAME OF OFFICEHOLDER OR CANDIDATE <br /> NAME OFOFFICEHOLDER OR CANDIDATE <br /> r.:�y:a�?�:I.rF.Y Ci:7:LX�i <br /> OFFICE SOUGHT OR HELD <br /> �a .r, •..c_.1 �.: .I � <br /> ❑sUPPOHi <br /> ❑OPPOSE <br /> ❑ SUPPOpT <br /> ❑OPPOSE <br /> ❑SUPPOFiT <br /> ❑OPPOSE <br /> I have used all reasonable diligence in preparing and reviewing this statement and to the best of rty Imowledge the information contained herein and in the attached schedules <br /> is true and complete. I ceAify under panalty of perjury under the laws of the State of CalNornia that the foregoing is true and cortect. <br /> Exeeuted on � � <br /> � \ <br /> El(6CUiBf�OR�_ � V � v `� <br /> W7E <br /> Executed on <br /> w� <br /> `.�E7lBCUiBd Ofl <br /> DATE <br /> cor+rHa.uNo <br /> TRE/�SURER OR ASSISTAM TRE�SURER <br /> vnovorm�r <br /> 610W1iUiE OF CONTNOILINO OFFlCE/KKDER.CANdWTE.STAIE AEIISURE PflOPIXJENT <br /> � <br /> SIOIU7UFE OF CONTROLLINO OFFICEHOIDER,CANOIDATE.STATE MEASURE PROPONENT <br /> FPPC Form�60(&99) <br /> For Teehnieal bsistanee: 916/3ffi-5660 <br /> State of Califomis <br />