410 Amendment
Statement of Organization
Recipient Committee
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Statement Type
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List 1.0 number:
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1. Committee Information
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2. Treasurer and Other Principal Officers
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3. Verification
I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein IS true and complete I certify under penalty of
perjury under the laws of the State of California that the foregOing is true and correct
Executed on ~-.J- () 7 By
DATE
Executed on By
DATE
Executed on By
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Executed on By
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S,G\A~1.,~E':7TREASUR~ER 2f ~SSiS~".\- C'?EASURER
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S GNATGRE 0" CC~CROLc ['.;G OFFiCEHOLDER C.AN~ - _ -OR S' A-E VlEASURE PRO~ONEN i
SIG'JAT GRE OF CC~TRC_Li'JG ClFFICEHClLDER CAN8 DATE 0" S-ATE MEASURE PRCPONENT
SIGNATURE OF CONTROLclNG OFFICEHOLDER. CAND,DATE. OR STATE MEASURE PROPONENT
FPPC Form 410 (January/05)
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