Laserfiche WebLink
Officeholder, Candidate, T,~...,. hink. COVER PAGE- LONG FORM <br />and Controlled Committee st.,...~ cove. pellod Date Stamp <br />Campaign Statement -- Long Form f,o. 0~-~, ,-.,/~, /~ q ~ <br />(Government Code SIctK)m B420()-~4~ 1&.5) <br /> <br />Check one d the following bones to indicote the type of statemem binS flied: Dote of eiK~ion if eppfici~le: <br /> ;,.~Stat.m..t (U.d~D,y.V.,) FIB 1 <br /> Supplemental Pre-election Statement (Attach a completed Form 495 to this statement.) <br /> SpKiol Ocld-Yur Compa~n ReI)Mt <br /> ~ C~TY CLERK <br /> Termination Statement CKttKh · completed Form ·15 to this stBtemlnt.) <br /> !fit: <br /> Incl, lis Statement cMw.m..s.o, indud... ,d, con,d~,~.mm.f that.., com. o~bv yo~ <br /> co, nm~ees of y, fW.h you haw knowded~ (t~f em INtn~dly fo, mad ~o ,eceh, e COmdMdk)rd <br /> NAM~ OF OFflCEHOLOEA OA CANOIDATE <br /> <br /> MMI)~NT/A~ O~ BUSJIdESS A~OMS$ - {NO. AN0 STIE(T) / IMM( O~ TMASUBlt CONTROLLED COidlm. <br /> OW STAT! ~P (GOt NnI, A COO~GAYI1ME ~ CQMMITVH AOOMSS INO. AN0 STInt'T) <br /> COMMITTEE I~I, ME / / ~. mMMa C~r STA~I Zl~ CM)i ARi~ CO~YTJME <br /> <br /> i COldi~TI! ADOIESS ~O, ANO SIMll~ <br /> STATE Z]P Cae( AJ~A CO(]f,~AI~ME PHONE NAME ~ 1111ASUIIEll <br /> NAME OF TREASURER . - cmlllmll AKXIHS IN0. AN0 STMITI ' <br /> N~ A~ealss of IiiEASi·i~ii ~llO, ANO STRIWI1 ~ C~Y STAT! ~ CO(a( AA~A L'OiX4)AYTa~ ~ <br /> <br />iii Verification <br /> ! have used oil remonaMe diligence in preparing this statement. I hove reviewed the statement* incl. to.the bi?t. of my k~ ~ inf?~m~tion contained h~ ein ~d in the attached schedules is <br /> I true end completl. Ic~tifyunderl~naltyofpMjuf~underthelawsoftheSt4tlOfCalifommthatt~f~trde~cmf~- / / /./~. - <br /> <br /> An offkehoidM M ondldMe who cant,ds · cmnd~ mud lisa verify h c4mplign statement. I have used ·11 fea~. ibl~ dJ!~gence a?d to t~e best of. mY.knowl .e~lge, the tr,eJ, su~e_r hlS:ndS~ <br /> feasoMble dJl~ence iff prep~r~ this itttement. I fmve reviewed the statement and to the best of my knowledge the mfMmat~ contmned harem and m the attacMd scneaum ~s true <br /> complete. I certify und·r p~rmlty of perjury under the laws of the State of~C·#fMnLI th·t the forngmng is true ·nd correct <br /> <br /> [aKuted On At By <br /> DAT! ~ AM) STATE S~6NAIUM OI CAWlWt~L~HOLD~A <br /> <br /> ExKuted on. At By <br /> DAlE OTY AMO SLATE SIGNAIU~ Of CAId)4OAII~OHICIHQ4.MR <br /> <br /> lOdl I~OlIMAVM IMQUIMD TO BE fllOvIo(o TO YOU FUIISUANV IO IHE I~OAMAII041 INMCTICIS AC~ O~ 1177. ill ~Nf4~dAIION MANUAL Q~ CAMPAIGN DIKLOSUI~ MIO¥ISK~S O~ THE POLITICAL AEFONd <br /> <br /> <br />