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COVER PAGE -- LONG FORM <br />Recipient Committee Type or Print in Ink. Statement coyote p~t4od DaM S <br />Campaign Statement -- Long Form I ~ ~~~ <br />(O~e~em C~e S~fiom 842~-~216.5) f~ <br /> <br />Cbk oH of lb folbwl~ hxoo lo I~cmlo lb ty~ of olllmnt bol~ fll~ Date of EIKllon ~ A ~ Offichl Use ~y <br /> <br />D Pre-elation Stateme~ ~ S~i-aflflual Slatemem If appllcabb: ~' .~ ,~" <br />~ Special Odd-year Ca~aign Repo~ IMontk Day, Yaar) C TY , ~ <br />~ Suppl~ental Pre-elation State~nt (AUach a c~leted Form 495 to this stale~nt.) ~ <br />~ Tam)nation Slate~flt (AUach a c~eted From 415 to Ihis statement.) <br /> <br />I Committee Information II Primaflly Formed Committee (See definition on reverse.) <br />List nares of omcehoJder(s) or candidate(s) for which this <br />co--tree <br />is <br />~ (~F CO~MMITI EE: prlmrily <br />lo~d <br />(C~ck Bo~s) See ~finitio~ a~ ~rt~t ~tion on re~rse. <br />Is ~is a s~r~ commits? .................................... D Yes ~ No <br />Is ~is a br~ ~ ~lifi~ ~mit~? ................... D Yes ~ <br />No <br />Ankh ~i~l ~ ~ ~ri~e0 ~ ~i~i~ ~s. <br />I have u~ all re~nable dilige~ in p~ng ~s s~ment ~d to ~e ~st of m~ k~wl~ge ~ inf~a~ ~mi~ ~ein and in ~e a~ ~h~ul~ ~ ~ and <br />E~u~ on ~. <br />F~ IN~l~ ~EQUIRED 10 BE ~OVOEO 10 Y~ P~ANT TO THE INF~MA~N P~CllCE~ ~ ~ 1977. ~EE ~T~ ~ ~ ~A~ ~l~t ~ ~ ~ ~ ~IT~AI ~F~M ACT <br />State of Calllo~a Fair Political Practices Cmmlotlo~ <br /> <br /> <br />