Laserfiche WebLink
COVER PAGE -- LONG FORM <br />Recipient Committee Type or Print In Ink.' Statement cover8 periodI <br />Campaign- Statement- Long Form I ~~ ~~~ ~ ~ ~ '~ ~ <br />(Gove~ent C~e S~fio~ 842~-~216.5) - f~m ~ , :~ <br /> <br />~ Pm-el~li~Sialeme~ ~ Se~-~ualSlaleme~ Ilappllcable: ~ <br />~ Special~d-yea~ C~aign Repo~ (Monl~ Day, Year)~ ~~~,1~,.~ e~ -~ .~- <br />~ Suppl~ntal Pre-el~tion Slale~ (Aaach a c~leled Fo~m 495 lo Ihis Slate~nt.) <br />~ ~m~nation Slate~nl (Aaach a c~ated Folm 415 to Ihis state~nL ) <br /> <br /> I Committee information II Primarily Formed Comndttee (See definition on reverse.) <br /> List names of officeholder(s) or candidate(s) for which this <br /> ,t, utc~cet~v,.EE: committee is primarily formed <br /> (C~ck Bo~s) See ~finitio~ a~ ~rtant ~tion on reverse. <br /> is ~is a s~n~r~ commits? .................................... ~ Yes ~ No <br /> Is ~is a br~ ~ ~li~l ~mit~? ................... ~ Yes ~ No <br /> Au~h ~i~l ~n ~ ~opri~e0 ~lM c~i~i~ <br /> Ill ~arlflcation <br /> I ~ve u~ all re~ble dilige~ in pre~ng ~s sm~ment ~d to Ihe ~st of m~ k~wl~ge ~ inflation ~mi~ h~ein and in ~e at~h~ schedul~ is ~ and <br /> E~u~ ~ ~ <br /> E~u~ ~ ~ <br /> <br /> <br />