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COVER PAGE <br />Recipient Committee <br />Campaign Statement LOCALType or print in ink, <br />(Government Code Sec6ons 84200-84216.5) <br /> Statement covers period Date of election if applicable: NOV ~ <br /> <br />1.. Type of Recipient Committee: AIICommtttees-CompletePartsl,2,:~,andT. 2. Type of Statement: <br /> <br /> J~ Officeholder, Candidate [] Pdmadly Formed Candidate/ [] Pre-election Statement [] Quarterly Statement <br /> / 'Controlled Committee Officeholder Commitlee [] Semi-annual Statement [] Special Odd-Year Report <br /> (Also Complete Part 4.) (Also Complete Part 6.) ~'ermination Statement [] Supplemental Pre-election <br /> [] Ballot Measure Committee [] General Purpose Committee ~[] Amendment (Explain below) Statement - Attach Form 495 <br /> O Primarily Formed O Sponsored <br /> © Controlled © Broad Based <br /> © Sponsored <br /> (Also Complete Part 5.) <br /> <br />3. Committee Information I "D'U~qT/'~,~ Treasurer(s) <br /> COMMI'CI'EE NAME NAME O,.O_F~F TREAS U R E~ <br /> <br /> STATE ZIP CODE AREA CODE/PHONE NAME'OF ASSISTAN-r TREASURE~, IFANY <br /> MAILING ADDRESS (IF DIFFERENT) ~10. AND STREET OR P.O. BOX MA~LING ADDRESS <br /> <br /> CITY STATE ZIP CODE AREA COD E/PHONE CITY STATE ZIP CODE AREA COOF-/PHONE <br /> <br /> OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/E-MAIL ADDRESS <br /> <br /> FPPC Form 490 (8/99) <br /> For Technical Assistance: 916/322-5660 ,, <br /> · State of California <br /> I <br /> <br /> <br />