460 Recipient Committee Campaign Statement 6-30-12 Amendment COVER PAGE
Recipient Committee ,Type or print in ink. s �� .�
C
Campaign Statement !) is ii U 4:,FFORM oRNIA 460
Cover Page
(Government Code Sections 84200-84216.5) !' _ ) of e!
Statement covers period Date of election if applica�r OCT 1
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(Month, Day, Year) a u••r Official Use Only
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SEE INSTRUCTIONS ON REVERSE through 6 - 3 67- .?-0/ 2' / (- .�0 J, PERTINQ CITY CL:RK
1. Type of Recipient Committee: All Committees-Complete Parts 1,2,3,and 4. 2. Type of Statement:
[ Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement
Q State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd-Year Report
Recall 0 Controlled ❑ Termination Statement El Supplemental Preelection
(Also Complete Part 5) 0 Sponsored (Also file a Form 410 Termination) Statement-Attach Form 495
(Also Complete Part 6)
❑ General Purpose Committee Amendment (Explain below)
Q Sponsored ❑ Primarily Formed Candidate/
O Small Contributor Committee Officeholder Committee u��� ��' 7H�� ��M
O Political Party/Central Committee (Also Complete Part 7)
3. Committee Information I.D. NUMBER Treasurer(s)
COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER
.5CL ci4 ' 67
/� MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/E-MAIL ADDRESS
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules 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 9 /24f/� By / , • --
Date Signature off surer or Assistant T4surer 0
Executed on 9/34-/C—).--- By �. Lf���w,
Date Signature of Cont.,a,Te ceholder, andidate, "asure Proponent or Responsible Officer of Sponsor
Executed on By
Date Signature of Controlling Officeholder,Candidate,State Measure Proponent
Executed on By
Date Signature of Controlling Officeholder,Candidate,State Measure Proponent
FPPC Form 460(January/05)
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