460 Amendment ecipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
n ~~ -0
Type or print In ink. ~a -
m
-~
r-
Statement covers period
] ~ ,- ZO O~j
from Date of election If applicable:
(Month, Day, Year) Z
0
~ ~
--~
through br. J~ ~ZdoU ~ ] ^ `~-~O ~ .~
1. Type of Recipient Committee: All committees -complete Parts 1, z, 3, and a.
Officeholder, Candidate Controlled Committee [] Primarily Formed Ballot Measure
Q State Candidate Election Committee Committee
Q Recall Q Controlled
(AlsoComple(ePad5) Q Sponsored
^ General Purpose Committee (Also Complete Pad 6)
Q Sponsored ^ Primarily Formed Candidate/
Q Small Contributor Committee Officeholder Committee
Q Political Party/Central Committee (Also Complete Pad 7)
3. Committee Information I I.°i~QE~
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) =1
~I..I3~-~~ C . C-~-~ ~ -~oY G~ Coy N C.~ L.
STREET ADDRESS (NO P.O. BOX)
! 0 ZLFZ C~aLL~-tJCO ~ !~P 1 y~
CITY STATE ZIP CODE AREA CODE/PHONE
Cu~~e-r nld C,Ps . qSo - 4- ~FnB-`1°i~--1 ~
MAILING ADDRESS (IF DIFFERE T) NO. AND STREET OR P.O. BOX
t~1A
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
2. Type of Statement: ffl
^ Preelection Statement ~
^ Semi-annual Statement
^ Termination Statement
(Also file a Form 410 Termination)
,~ Amendment (Explain below)
OS--
Treasurer(s)
COVER PAGE
of
For Official Use Only
stamen[
a dd-Year Report
^ Supplemental Preelection
Statement -Attach Form 495
-7"0 f /I/oS - G
NAM OF TREASURER
IV~
MAILING ADDRESS
CIT~ `OI1.~ ,~
NAME t F ASSISTANT l
~~ I y~
STATE ZIP CODE
ANY
MAILING ADDRESS
CITY
STATE ZIP CODE
A~REA~CODE/PHONE
5..~~~I
AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and io the best of my knowledge the inf rmation contained erein and in the attached schedules is true and complete. I certify
under penalty of perjury under't~h~e laws of the S(ta~te of Califomia that the foregoing is true an c ecCS
Executed on ~ ~ ~- ~ 1` ~ ~ c ~ By `
ale Q Si nelureofTreas Ass' tanlTreesurer
Executed on __- ^ 20~- O y By
ale - c~~~r~ko.,r r...a...m....rwa..d..awe, r.,...ca..1., c...~....---.._~.-........._'_-^--__:~~_,.a_
Executed on By
Dad Signature of Controlling Officehdder, Candidate, Stale Measure Proponent
Executed on gy
Date SignalureofConlmllingOfficehdder,Candidete,5lateMeasurepmponent FPPC Form 480 (Jenuery)OS)
FPPC Toll-Free Helpline: B681ASK-FPPC (8661275-7772)
State of California