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2ecipient Commitfiee c°v�Ranc� <br /> :ampaign Statement TYPe or print in ink. Date SWmp o - , <br /> � � • <br /> :over Page [� (� � � d � D ' <br /> 3ovemment Code Sections 84200-84216.5) I page_� of �- <br /> Stateme t co rs period Date of election if applicabl AUG 2�6'�2010 � <br /> (Month, Day,Vear) For Oniciai Use Ony <br /> from <br /> 9 . . CITY�CITY CLERKD CITY <br /> EE INSTRUCTIONS ON REVERSE through Q� JO ID <br /> . Type of Recipient Committee: nn commiaeea-wmPiece varo+,z,a,a�a+. 2. Type of SWtement: <br /> ❑ Officeholder.Candidate Controlled Committee � Primarily Formed Ballot Measure ❑ Preelection Statement � Quarterly Statement <br /> OStateCandidateElectionCommittee Committee . Semi-annualStatement <br /> � Q Recall Q Controlled �' ❑ Special Odd-Year Report <br /> ❑ TertninationStatement � SupplementalPreelection <br /> (AlsoCOmpa(aPnrt5) � Sponsored Also file a Form 41 Termination <br /> �asocomPareaerte� ( � Statement-AtlachForm495 <br /> � General Puryose Committee ❑ Amendment(Explain below) <br /> Q Sponsored � Primarily Fortned Candidate/ <br /> QSmaIlContributorCommittee OfficeholderCommittee <br /> QPoliticalPariy/CentralCommittee (asoca.,Pkbrerc�l <br /> �. Committee Information �� u"" E (l Treasurer(s) <br /> COMMITTEE NAME (OR C OID TE'S NAME IF 0 COMMITTEE) NAME OF TREASURER <br /> �C7if�zEi✓s �n ��eorr�T��v��Gry a�-�ea�� c� ���v <br /> f'OL/71CAL f1GTlDNC111�/-f���C MAILINGADDRes� <br /> <br /> <br /> � R�v�oo� C�rv Ca 9s�o�� <br /> <br /> <br /> MA�INOG ADORESS.(If O1F�RENT) NO.AND STREET OR P.O. BOX MAILING ADDRESS <br /> t ) �) / �Z <br /> �— � ,c, co <br /> CIT STAiE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE ' AREA CODE/PHONE <br /> ��OWDOI� G1� CA 9�foG/ <br /> OPTIONAL: FAX/E-MAIL ADDRE 5 OPTIONAL: SA3FYE�MAIL ADDRESS <br /> � <br /> . Verificatian <br /> I have used all reasonable diligence in p2paring and reviewing this statement and to the best of my kn the'nformafion contained herein and in the attached schedules is true and complete. I certiry <br /> under penalty of perjury under the laws of the Sfate of California that the foregoing is true and covect. <br /> Fxecuted on �/ �a/ By <br /> Date 5' aWreolTr�smerorASSbimitTreawrer <br /> Fxecuted on By � <br /> Oate S ature fC IIBg�ceholdeqCendidata,SlabMeawmPmponaMOrftespon5i�leOXimrof5ponsor <br /> Executetl on By <br /> Date SigretureMCoMmlfinp011ca�oltlei,CeMitlate,Stetahbnsve ProponaM <br /> E�cecuted an By <br /> D�e Signelueo/CoMmIGp OrtkelpWe�,Cantlidate,S�ele Meaaue ProponeN <br /> FPPC Form 460(Januaryl05) <br /> FPPC Toll-Free HeIDline:BB6IASK-FPPC(966/275�J772� <br /> State of Calilomia <br />