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COVER PAGE <br />'" "-: 'Mec,p,ent Committee Type or print in ink.,' Date Stamp <br />Campaign Statement <br />(Government Code Seclions 84200-84216.5) --~ ~ <br /> Statement covers period Date of e~ection if applicable: of <br /> from [O/1'7/~. (Month, Day, Year) JAN 3 1 Z000 <br />SEE INSTRUCTIONS ON REVERSE through I ~-~>1 I~b"~ I~L3 Z. to) ~'~ CiTY OF RE~WOOD CITY <br /> · ' ' t ~ CiTY CLERK <br /> <br />1. Type of Recipient Committee: All Committees- Complete Parts 1, 2, 3, and 7. 2. Type of Statement: <br /> iii Officeholder, Candidate [] Primarily Formed Candidate/ [] Pre-election Statement [] Quarterly Statement <br /> Controlled Committee Officeholder Committee ~ Semi-annual Statement [] Special Odd-Year Report <br /> (Also Complete Part 4.) (Also Complete Part 6.) [] Termination Statement [] Supplemental Pre-election <br /> [] Ballot Measure Committee [] General Purpose Committee <br /> [] Amendment (Explain below) Statement - Attach Form 495 <br /> O Primarily Formed O Sponsored <br /> O Controlled O Broad Based <br /> O Sponsored <br /> (Also Complete Part 5.) <br /> <br /> I I.D. NUMBER <br />3. Committee Information ~5'!190 Treasurer(s) <br /> COMMITi'EE NAME NAME OF TREASURER <br /> <br /> MAILING ADDRESS <br /> <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> <br /> MA,..G D. ESS<,FD,FFERE ,.O.*"DSTREETO"".O. SOX MA,L,.G "ESS <br /> <br /> CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE <br /> <br /> OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS <br /> <br /> FPPC Form 460 (8/99) <br /> For Technical Assistance: 916/322-5660 <br /> State of C~lifornla <br /> <br /> <br />