Laserfiche WebLink
Recipient Committee <br />Campaign Statement <br />Cover Page <br />(Government Code Sections 84200-84216.5) <br />Type or print in ink. <br />Statement covers period <br />STREET ADDRESS (NO P.O. BOX) <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />STATE ZIP CODE AREA CODE/PHONE <br />4. Verification <br />I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. I certify <br />under penalty of perjury under the laws of the State of California that the foregoing is true and correct. <br />09/21/15 By <br />Executed on <br />Date j / Sig�tatureo surer or Assistant Treasurer <br />Executed on By V // <br />Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor <br />Executed on By <br />Date Signature of Controlling Officeholder, Candidate, Stale MeasureProponent <br />Executed on By <br />Date Signature ofControlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) <br />FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275.3772) <br />State of California <br />