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COVER PAGE - LONG FORM <br />Recipient Committee Date Stamp <br />Campaign Statement <br />(Govemment Code Sections 84200 - 84216.5) ~ ~ ~ I ~I ~ Pa~e 1 of 3'7 <br /> ~....~..,.,.,~ ~.~..~o... JUL 3 ~. 2003 A ForOff3cialUseOnly <br /> <br /> · om 0~/0~./2003 <br /> through 06/30/2003 03/02/2004 Cii} OrC!TYn~_,J;',~.,O~C~_~R~ CITY <br /> <br />1. Type of Recipient Committee: 2. Type of Statement: <br /> [] Officeholder, Candidate Controlled Committee [] Ballot Measure Committee [] Pre-election Statement [] Quarterly Statement <br /> ~) State Candidate Election Committee O pdrnarily Formed [] Semi-anneal Statement [] Special Odd-Year Report <br /> O Recall O Controlled [] Termination Statement [] Supplemental Pre-election <br /> O Sponsored [] Amendment (Explain below) Statement - Attach Form 495 <br /> [] General Purpose Committee <br /> O Sponsored [] Pdmadly Formed Candidate <br /> O Small Contributor Committee Officeholder Committee <br /> O Political Party/Central Committee <br /> <br /> I,.e..o..E. Treasurer(s) <br />3. Committee Information ~2s280~ <br /> <br /> COMMITTEE NAME N,~MIE OF TREASURER <br /> :Ira Rusk±n Democra~- for Assembly AsA <br /> STREE~ ADDRESS <br /> <br /> STREETADDRESS(NOPO. BOX) 125 S. Nark:e'c S'creet., Sn~_'ce 1160 <br /> <br /> 1001 Tr±S St.z:ee'c c~w STATE ZIPCOOE AREACODEJPHONE <br /> <br /> 5a~1 ~Tose CA 95113 (408) 297-3795 <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> Reciwoocl C~.t-~' CA 94061 (650) 261-1410 NAMEOFASSISTANTI~EASURER, IFANY <br /> <br /> STREET ADDRESS (IF DIFFERENT) NO. AND STREET OR PO BOX <br /> EIREET ADDRESS <br /> <br /> CITY STATE ZIP CCOE AREA CODE/PHONE <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> <br /> OPTIONAL: FAY~:-MAI L ADDRESS ( ) <br /> (650) 365-7210/ OpI]ONAL:FAXlE-MAILADDRESS <br /> <br />4. Verification <br /> I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the inf~a~contained <br /> herein <br /> and <br /> in <br /> the <br /> attached <br /> is tree and complete. I certify underj)enalty of pel~ury under the laws of the State of Califomia that the forego~ isle and c~ect. ~ <br /> <br /> Executedon //~'~,~---~ ~_~ By ~TR0[.~R,C~m~DD[D~E.i,TAT[:r~su.[.~O.(N~E~.O~RE~PON~,BLEOFFiC[.OFSP~SOR <br /> Exaculed on By <br /> <br /> Executed on By <br />S/CCW - PCAB05 01380 (Rev. 9/99) State of California Fair Political Practices Commission. <br /> <br /> <br />