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i <br /> Officeholder, Candidate, Typeor print in ink. COVER PAGE- LONG FORM <br /> <br /> and Controlled Committee state,,.t covers period Date Stamp <br /> Campaign Statement -- Long Form f,om ~___~L~_2 .______ <br /> (Giver nment Code Sections 84200-84216.5) through ~/.~/~:~7 <br /> SEE INSTRUCTIONS ON REVERSE -' ' <br /> Check one of the following boxes to indicate the type of statement being filed: Date of election if applica~le: Ilia ! For Official Use Only <br /> ~ (M~.th. O,. Y,,,) -- JUL 2 51997 <br /> Supplemental Pre-election Statement (Attach a completed Form 495 to this statement.) <br /> B Pre-election Statement <br /> Supplement BI Pre-elect <br /> r-~ special Odd-Year Campaign Report <br /> [] Semi-annual Statement ~ OF REDWOOD CITY <br /> ~ Termination Statement (Attach i c°mpletedForm 415 to this statement-) ~IT~ ~[ERK <br /> II --Officeholder. Candidate, and Controlled Committee II Other Committees lot Included in tills ~tate nent: us~anyot~e, <br /> Included in this Statement corem/trees not included in this consolidated statement that are controlled by you and any <br /> corem/trees of which you have knowledge that are I~madly fo~med to receive contributions <br /> NAME Of OFFICEHOLDER OR CANDIDATE M to make expend/lures on beha/f of your candk~tTf. <br /> <br /> OFFICE SO~HT Da H~LD (INCLUDE LOCATION AND DISTRICT NUMBER IE AI~'MCABLE) <br /> <br /> I-'! v. I-! .o <br /> <br /> C/TY STATE ZIP CODE COMMITTEE ADDRESS (NO. AND STI~ET) <br /> l~k~pu__~tr~D (~4'~ ~,- ~~ / <br /> COMMITTEE NAME I ~-I LD:NUM~ER CITY STATE ZJl)CODE AREA CODFJDAYTIME WE <br /> <br /> COMMITTEE ADDMSS (NO. AND STREET) <br /> I <br /> I <br /> <br /> C~I'Y STATE ZIP CO~E AREA CODEJOAYTe4E PHONE <br /> NAME OF TREASURER ' - COMMITTEE ~SS (NO. AND STI~EI~ "i I <br /> <br /> I~IIK~ ~SS OF I~MJ~EK ~10. ~ STI~ET) ~ STATE <br /> <br /> C~IY STATE Zl~ COC¢ AREA CC)M,~AYTIME FHOM <br /> AKach ~)dldol141Mformadol~ o1~ elAoroprlately lebeled cM)tinuatlo~ sheets. <br /> <br /> III Verification <br /> <br /> i truei~comp~ ice~i~un~r~na~of ~juryun~rt~elawsoftheS~ofCalif~niathatthefor~istr~o~- ~ ~ <br /> <br /> An offlceho~m m ~ate who (ontr~s a comm~ee must also verify t~ campaign statement. I have u~d all reasonable diligence and tithe ~st of my kn~ledge the treasurer has used all <br /> reasonable dilige~e in pre~ri~ this statement. I have rewewed the statement and to the ~ of my kn~ledge the information contained herein and in the a~ached ~hedules is true and <br /> complete. I ce~i~ ~nde~ ~nalty of ~rju~ unde~he laws of the State of California [h~t the toregoing is true an~.e~.. <br /> <br /> -- DATE "9- C~Y ~ND ~TATE ~ - I S~lU~ O~ <br /> ExecuTed on At By <br />~ DATE CflY AND STATE SIGNATU~ O~ ~NDIDAI~F~EWDER <br /> <br /> Executed on At By <br /> DAIE CITY AND STATE SIGNAIURE M ~NDIDATE~f~E~LDER <br /> <br /> FOR INflATION ~I~D ~O BE PROVIDED 10 Y~ PURSUANT TO THE IN~OMAI~N P~KES A~ OF 1~77. SEE IN~ORMATION MAN~AL ~N ~MPAIGN DISCLOSURE PROVISIONS ~ <br /> <br /> <br />