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CiTY CLER,~ OEPARTHE~T I ~)N¢; t{ ~ M <br />Officeholder, Candidate, Type or Pdnl In I~. Stalemenl cove. pe,iod <br /> <br />and Controlled Committee <br />Campaign Statement -- Long Form J N <br />SEE I~TflUCTIONS ON flE~fl~ l~h I~-~-~ <br /> C~k a el Ih lelbw~ ~lee lo i~eale I~ ly~ el ~lllal ~ N~ ~ale el ialh <br /> ~ ~pp~ Pfe-~l~ ~a~l (Alla~ a ~led F~m 495 Io I~s aae~l ) {~nl~ ~y~ <br /> <br />I O~e~f~ Gl~ll~ II Ol~r C~ll~s Not I~lad in ail 6tale~nt= <br /> IKl~d in t~s S~temnt c~Ute. ~ w~ch ~ ~ ~dge I~ ~e pr~i~ /~d w receive c~rib~iom or <br /> <br /> ~lO_~ ~. ~t~ ~""~ <br /> <br /> C~EE ~ (~ ~S1~) <br /> ~IY SLATE ZF ~ ~ ~M ~ ~ ~ l~: C~1~0 <br /> <br /> ~V tlAIe ZF ~ ~ ~WM ~ <br /> <br />Il Vmilk~ation OIIieohold.r m Candidate: <br />troanurer: i have used all rcasmalde diligence and lo thc best of my knowlcdgc thc I~casurcr has <br />I have uscd all rcasonablc dilisencc in pfcpadn8 this slalcmcm and lo Iht bcs; o[ my used ali fcasonable diliscnce in ptcpafin8 Ibis siaicmcm. I havc rcvicwcd Ibc smtc- <br />knowlcdBc II~ infoflnation contained herein and in Ibc auachcd schedules is true and mca and Io the I)cst of my knowlcdgc thc in~oflnaii(m coniaingd hcrcin and in thc <br />complclc. I ccrdfy undcf pcnallyo[ pcrjmy undcr Ibc laws o[ thc Slat o~ California auachcd schcdulcs is truc and complcic. I ccnify under pcnalty o[ pcrjmy undcr thc <br />Ihal Ihc fmcgoing is line and cmtcct laws of Ihe Slate of California Ilml thc fmcgoing is uue and cmtccl. <br /> <br /> By SIGNAIURE OE TREASURER ~'~- SIGNATUflE OF OFFICEHOLOER OR CANDIDATE <br /> <br /> tOH Iiq~OHMAI#)FI FII:(~HliED lOBE PflOVID£1) IO <br /> SI&lo ol Celllornll Flir Polill;&l Pfacli¢o~ Com~ti~aion. <br /> <br /> <br />