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' COVER PAGE <br />Recipient Committee Type or print in ink. Date Stamp <br />Campaign Statement <br />(Government Code Sections 84200-84216.5) ti'"'~ I--~ (~ !'~ ~ ~i7 ~ <br /> Statement covers period Date of election if applical~l~: ~ !'~' IL IJ ~'/ ~ e <br /> from ~--~~ (Month, Day, Year)_~_~::~i~ J~N ~, ~ ~000 ~ For ~icial Use Only <br />SEE INSTRUCTIONS ON REVERSE through /~ - ~/-- ~ It <br /> <br />1,~e of Recipient CommiRee: AIIC-mmiUees-CompletePa~sl,2,3, and7. 2. Type of Statement: <br /> ~ ~fficeholder, Candidate Primarily Formed Candidate/ ~ Pre-election Statement ~ Qua~erly Statement <br /> Controlled Committee Officeholder Committee ~Semi-annual Statement ~ Special Odd-Year Repo~ <br /> (Also Complete Pa~ 4.) (Also Complete Pa~ ~) ~ Termination Statement ~ Supplemental Pre-election <br /> ~ Ballot Measure Commi~ee ~ General Purpose Committee ~ Amendment (Explain below) Statement - Attach Form 495 <br /> ~ Primarily Formed O Sponsored <br /> O Controlled O Broad Based <br /> O Sponsored <br /> (A/¢o Complete Pa~ ~) <br /> <br />3. Committee Information I I'D'NUMB~'¢/O~ Treasurer(s) <br /> COMMITTEE NAME NAME OF TREASURER <br /> <br /> STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE <br /> <br /> CITY ~~t~ ~d C~' h/ STATE ziP~r.~ CODE ~P~O~ AREA.~ CODE/PHONENAME OF ASSI~r~ASURER'/~//r~ IF A <br /> MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS <br /> <br /> CiTY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE <br /> <br /> OPTIONAL: FAX/E-MAILADDRESS OPTIONAL: FAX/E-MAILADDRESS <br /> <br /> FPPC Form 460 (8/99) <br /> For Technical Assistance: 916/322-5660 <br /> State of California <br /> <br /> <br />