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Home My WebLink About410s AMENDMENT Amendment to Type or Print In ink Date Stamp e Campaign Disclosure Statement 7 AF� e Only This form must be used to amend statements filed pursuant to Government Code Sections 84200 - 84216.5, and must be filed with all filing officers who received tire statement being amended. NOTE: Do not use this form to amend a Statement of Organization, Fonn 410, Candidate Intention, Form 501, or a Campaign Bank Account, Form 502. Use the actual Form 410, 501 or 502, respectively, to make amendments. The information required in Part 1 must correspond to the information provided on the campaign statement. Name of Fifer (See important information on reverse) ° I " 11 Amendment Information _ IW APPLICABLEI no following in ,t [' / � Z�D�� " executed on' t" � for the period N � through !!! LW.WY.YR) IW. MY, TRI TAU. MY. Yfl.I MAILING RESS W RL INq. ANO stn f B. The amended information effects items on the: �ilz ❑ cover Page ❑ Allocation Pa1gge,� ❑ Summary Page CITY �� / STATE ZIP CODE El G Schedusts) ` rargs) /1e' / t � 7 (( 1 (? �! yG 7 / y/ C. Describe the changes below. Include in detail all information you wish to become a pan of ' AREA CODFNAYIIME RIONEEk NU BER your official campaign statement. Please attach a cover page, summary page and /or appropriate schedule(s) to this Form 405 If necessary for clarification. Include additional j information on appropriately labeled continuation sheets. MAYS F REAAYRE IF RECIPIENT CJDMMITTEEI (Number of Sheets attached .) PERIMNENT ADDRESSOF TREASURER QF AFRICA (NO. ANDSIREET) 542f P Q5 4flad� CITY STATE DP CODE ��( `✓• E7 (� /�S , AREA CODFIDAYTIME RZONE NUMBER III Verification (See important information on reverse) 1 have used all reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my knowledge the information contained herein and in the attached schedules is we and corn / p r lete. 1 certify under penalty ofo/ejr /jury under the laws of the State of California that the (Dreg mg is troy pnd Corr Executed on � / � 7Z At C "Y By DATE GIYAN S7 E TUBE OFI ROR FILER Officeholder, candidate, state measure proponent, or sponsored committee responsible officer verificati : have used all teas able diligence and to the best of my knowledge the treasurer has used all reasonable diligence in preparing this statement. 1 have reviewed the still in an o the best of my knowledge the illf aiion contained herein is we and complete. 1 certify nde ycrulity of perjury under the Is S of the St a of Ce a that the foregoing is on and Corr 1. Executed on //� At d �P�il��l�74 n (� B y - OA T - E —� CRYAN 5 ATE SIGNATURE OF OFIICEI O ID LDS .CAIDAIF WI NT RESPONSIBLE OFFICER Executed on At By BALE GIY ANO SIAIE SIGNAIIxE WOFNCEI IDI.Wn, CANUIDAIE W1 %T01'WENT Executed on At By ' DATE CIIY AND STATE SIGNATURE OF W FICFI xN or IT CAN)IDAIr Oil 1110TIL'Ofa NT FOR INFORMATION REQUIRED TO BE PROVIDED IO YOU PURSUANT TO TFIE INFORMATION PRACTICES ACT OF 1977 SEE INFORMATION MANUAL ON CAMPAIGN DtsCI OS 11 11EP _HOV12QUa4EIBEPOL1nCALBE[MAACI Stale of California Fair Political Practices Commission. ® r i ll - t;7, FILE AN ORIGI „ AND ONE IF APPLICABLE, FILi vNE COPY OF THIS FORM WITH: RAG, COP OF THIS FORM WITH: RECEIVE D Secretary of State The city or county filing officer, if any AND FILED , Political Reform Division with whom the committee must file its In Hre office of the Secretory of Stafe P.O. Box 1467 original campaign disclosure of the SNSte of Cohlornio Sacramento. CA. 95812 -1467 State " OCT 0 21989 Form 410 STATEMENT OF AI2R Q M COMMITTEE) 1989 -7 84103) fWCH FONG Ell. Serretagoi State r �� ( Gove��Qfg 'EBQCi56CtTiiri,S6WIi�� IFAM T COUNTY RIVERSIDE EN TER I.D. I.D. NU MBER or (Type or Print in Ink) FULL NAME OF COMMITT / E / (Y STREET ADDRESS OF COMMITTEE: AND STREET CITY STATE IPC E (NOT P.D. tlor) yiT, u�i ;dP�si�� MAILING ADDRESS (IF DIFFERENT): I NO.ANO SIR ET ON P.O. tlO %1 r o uAre NP t cooE j� T� �Z Z 3 U DATE QUA FIED AS� MITTEE,IM .,o r .� RkA CO PHONE Nura A FOR OFFICIAL USE ONLY B FOR OFFICIAL USE ONLY (/� / f / / 5( / �( / / I TREASU RAND OTHE R PRINCIPAL OFFICERS POSITION NAME AND ADDRESS AND MAILING ADDRESS, IF DIFFERENT (AREA BUSINESS CODE) PHONE NO. TREASURER ✓a /1V St ?U 7 /r' /lal - / / O.3 Attach additional informatio on app l abe l ed c ontinu a tion s heets. II IS THIS A BROAD BASED POLITICAL COMMITTEE7 (See definition and important information on reverse.) ❑ YES Enter the date on or before which the committee clualifed as abroad NO based committee: III IS THIS COMMITTEE CONTROLLED BY A CANDIDATE, OFFICEHOLDER OR STATE MEASURE PROPONENT? (See definition a Important information on reverse.) ((� YES (Complete the following) ❑ NO IF THIS COMMITTEE IS CONTROLLED BY AN OFFICEHOLDER OR A CANDIDATE, THE NAME OF THE CONTROLLING CANDIDATE OR OFFICEHOLDER, THE ELECTIVE OFFICE SOUGHT OR HELD AND DISTRICT NUMBER, IF ANY, MUST BE LISTED. IF THIS IS A BALLOT MEASURE COMMITTEE CONTROLLED BY MORE THAN ONE CANDIDATE, THE NAME OF EACH CONTROLLING CANDIDATE MUST BE LISTED. IF THIS COMMITTEE IS CONTROLLED BY A STATE MEASURE PROPONENT, THE NAME OF THE STATE MEASURE PROPONENT MUST BE LISTED. U / louWi --4 Attach additional information on appropriately labeled continuation s IV IS THIS COMMITTEE ACTING JOINTLY WITH OTHER COMMITTEES7 ❑ YES (Complete the followi 0 NAMES OF COMMITTEES WITH WHICH THIS COMMITTEE ACTS JOINTLY. ALSO PROVIDE THE COMMITTEES' IDENTIFICATION NUMBERS OR THE TREASURERS' NAMES AND PERMANENT STREET ADDRESSES. Attach additional informa tion on appropriately labeled continuation sheets. Y M COMPLETE THE VERIFICATI ON PAGE 2 Fcv :nlwmation required . to be provided to you pursuant to the Information Practices Oct of 1977, see "Information Manual on Cempargn Dsclosw e ,NAME OF COMMITTEE _ V IS THIS A SPONSORED COMMITTEE? (Refer to the instructions on the reverse side for definitions and rules regarding t,,he(y�me of a sponsored committee.) LJ NO ❑ YES (Provide name and address of sponsor. If the committee has more than one sponsor, provide the name and address of each sponsor on an attachment.) Name of Sponsor: Address of Sponsor: VI IF PRIMARILY FORMED TO SUPPORT OR OPPOSE SPECIFIC CANDIDATES OR MEASURES, LIST SPECIFIC CANDIDATES OR MEASURES SUPPORTED OR OPPOSED. CANDIDATE'S NAME /MEASURE'S FULL TITLE SUPPORT OPPOSE OFFICE SOUGHT OR HELD BY CANDIDATE OR MEASURE'S INCLUDING BALLOT NUMBER OR LETTER JURISDICTION (Include district number, city or county, asapplicable.) Attac additional information on appropriately labeled continuation sheets. VII COMMITTEE'S PRINCIPAL ACTIVITY IF NOT SUPPORTING OR POSING SPECIFIC CANDIDATES OR MEASURES --PLEASE CHECK BOX TO INDICATE THE COMMITTEE'S LEVEL OF ACTIVITY: CITY ❑ COUNTY ❑ STATE Attach additional informat o app l abe l e d continuation sheets. Vlll YOU MUST SPECIFY WHAT DISPOSITION WILL BE MADE OF SURPLUS FUNDS IN THE EVENT OF TERMINATION. 1' ltk 90 4 - Z �U VERIFICATION 6 L /I 1 HAVE USED ALL REASONABLE DILIGENCE I PREPARING THIS STATEMENT. I HAVE REVIEWED E STAT ENT D TO THE BEST F MY KNOWLEDGE THE INFORMATION CONTAINED HEREIN IS TRUE AND COMPLETE. (CERTIFY UNDER PENALTY OF PERJURY LINDE a U HE LAWS OF THE STATE OF CALIFOR HAT THE FOREGO G TRUE AND CORRECT. Ew EXECUTED ON AT BY (DATE / I �TY AND STATE) (SIGN U Of T A I EXECUTED ON 4 / " h/ AT C /VI [ (. �(, l� "/ BY (DATE) (CITY AND STATE ( SIGNATURE Of CONi0.0LLIN N IDA FFlCE LDER OR STATE MEASURE PROPONENT) EXECUTED ON AT BY (DATE) (CITY AND STATE) (SIGNATURE Of CONTROLLING CANDIDATE. OFFICEHOLDER OR STATE MEASURE PROPONENT) EXECUTED ON AT BY (DATE) (CITY AND STATE) (LGNA LURE OF CONTROLLING CANDIDATE. OFFICEHOLDER OR STATE MEASURE PROPONENT) SPAIE - f OFORGANI Statement of Organization Typo or Print In ink. Amendment 1y�A U: +IC SIanIp Recipient Committee .t r1 Check la+a if an Amendment ' F OR M. , _ (Govemment Code Sectionr 94101- 94107) and enter I.D. nuniM:r A Fa Official IJso Onl SEE INS ON R / / /� �!/ v R E C E I V E D Date qualifie a n ''1 I AND FILED File original and one copy of this form with: And, If applicable, file one copy of 4 li', I N 0 V 1 8 1992 1 I in M office of tie se: story of Stdk Secretary of Slate this form with: Committee :(M+.uh, D.y, Yc ) 1 of /r. Sesw d CaEfo•eio Political Reform Division The city or county officer, if any, who y.� P.O. Box 1467 receives 6, committee's original � � /CJ / y ++ _ NO V 2 3 M2 Sacramento, CA 95812 -1467 cam box if disclosure statements. ❑ Check b if nI yet qualified • — fOfIG tU. SOaatarr of 1 Committee Information 11 Treasurer and Other Principal Officers aFCOlotmEE: NAMt oc irf-Asu WILING AOURl159 (IF DIFFERF I IIbWCOMMITTEES) 73 J' CC4AW REE:( PO NO AND MEET Lowy - CITY STATE LIPCOOE ARFACOOE"YIIMERION1 CITY A ZIPCODE� NAMEANOIOSIII(Na OF011 �� 11'111 IPAI IICHNS) ZS %/ rl. l�� Ma C /Q - �o� ✓,%u�9�J ��1� . a SS ,D, � DaEE ' rj yp.MO � JQ TAfr PG B G O /op � ��y "F %17 77 %` / FES)� Gf / � U s C. r / yw / E 7�c IDNEf cm� � 7 o ( 1 � srnlE / �� D Attach additional inform lion on oppropr y labeled continuation sheets. III Controlled Committee i � s committee controlled by an officeholder, candidate, or state measure proponent? (See definition and important information on reverse.) Yes (Complete the following) ❑ No • If this committee is controlled by an officeholder or a candidate, list the name of the controlling officeholder or candidate, the elective office sought or held, and district number, if any. If this committee is controlled by more than one candidate, list the name of each controlling candidate. • If this committee is controlled by a stale measure proponent, list the name of the state measure proponent. If this commitlee is controlled by more titan one state measure proponent, fist the name of each state measure proponent. • If this committee acts jointly with another comrq d committee, list the name and identification number of the other controlled cmnminee. - -J Attach additional irVornunion on appropriately labeled continuation sheets. You must complete the Verification on Page 2. FOR INFORMATION REOUIRED TORE PROVIDED TO YOU PORSUANI 10111E INPORMAIKNI PRACTICES ACT OF 1971, SFF IMMMAIIQN MANUAL -ON CAWAIGzN DISCWA)RE MQVISION8DF THE Pa I fCg FILLOIWACj State of California Fair Political Practices Commission ' SI M FM1 NT OF ORGANIZATION Statement of Organization Typo or Print In Ink. Recipient Committee ra • ' SEE INS TRUCTIONSON REVERSE Attach additional information on appropriately labeled continuation sheets. Page s NAME OF COMWTTEE 1 -J pe- e_ke - �\. �� M LJV�oz IV Broad Based Committee (See definition and important information on reverse) If this is abroad based committee and wishes to make contributions to candidates in excess of the $2,5(10 contribution limit in connection with a special election, check the box below and enter the date on or before which the committee qualified as a broad based committee. (if the corrrnuttee is not a broad based comnnee, or does not wish to make contributions in excess of the $2,500 limit, do not complete this section.) ❑ Check box if this is a broad based committee. Enter the date on or before which the committee qualified as a broad based committee: (Aforah, Da Year) • V Sponsored Committee Is this a sponsored committee? ❑ Yes ❑ No (See instructions on reverse for definitions and rules regarding a sponsored commiree•s narne.) If yes, provide name and address of sponsor. If the committee has more than one sponsor, provide names and addresses on app labeled attachment. NAME OF SPONSCH • ADDRESS OF SPONSOR. NO ANO STREET CITY STATE ZPCODE V I Primarily Formed Committee If primarily formed to support or oppose specific candidates or measures, list specific candidates or measures below: CANDIDATE'S OFFICE SOUGHT OR HE[ D OR MEASURE'S JURISDICTION CHECK ONE CANDIDATE'S NAME OR MEASURE'S FULL TITLE INCLUDE BALLOT NO. OR LETTER) (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) wnrawr arrow alwowr orroar VII Committee's Primary Activity it Not Primarily Formed If not supporting or opposing specific candidates or pleasures, see instructions on reverse and check ONE box to ind if t i a: ❑ CITY Commltloo or ❑ COUNTY Committee or ❑ STATE Co rmdttoo PROVIDE BRIEF OESCRPTION OF ACINITY , • VIIIDisposition of Surplus Funds You must specify what disposition will be made of surplus funds in The event of lennination. • IX Verification T 1 have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is truo and I certify under penally of perjury under the 1 ws of the Slate of California that the foregoin is true correct. �' / Executed on �� AT ��t/� �/ By t /�� l /U ✓ ✓� /� / 7 ryAND SIA ' URE gFT�S'IIEpY, // / l% AT B / //. Executed on y ME CIiYANUSIAIE SIGMIIIDE OF ONIIlOL11NOOFOx:E3101 OER. LAI DALE, IXi STATE MEASURE. PIOPoNENT Executed on At By l MIE CITYANDSIAIE " SIGNAL UIa Of CON I It" 1ING Of IICf I NJI TIER. CANINDA If. OR STATE MEASURF PiIXVNI. NI Executed on At — ____ By RAIF. f.IITANUSIAIt. SKINA1011f 01 CONII1011INGOIfKAHOIDI.N CANIAMIt,011SIAMMI'ASIAxl'"O NINI STATEMENT OF ORGANIZATION Statement of Organization Type or Print In ink. Amendment Win Stamp Recipient Committee 94 r ' Check Aux if ul Amendment (Govemrnem Code Sections 84101-84103) and enmr I.D. number: _ , Z' A For 011icial Uso Only SEE INSTRUCTIONS ON REVERSE ' r 7 / ✓` [ ` y File original and one copy of this form with: And, If applicable, file one copy of Date qualified as Secretary of State thls form wllh: Committee :(Mmlh, D.y, Yc.r) Political Reform Division The city or county officer, if any, who / /I�� /�- . P.O. Box 1467 - . receives the conuniuce's original (J / - Sacramento, CA 95812 -1467 campaign disclosure statements. ❑ Check box B not yet qualified 1 Committee Information // 11 Treasurer a nd Othe /p Principal Officers NAME OF commi �� NAME OF IDEA ✓�/ ///� U /L MAILINGAWRESS. (IF DIFFERENT TITAN COMMITTEE'S) • AWIESS FCOMMWEE:(N P.O.BO%NO.AND 7REET CW : - CITY STATE ZIPCOUE AREA CODUDAYI IME PI IONS CITY A ZIP CODE NAME AND POSITION OF Oil Pill IPALODICER(Sr. MAILIN DDRESS: (IF DIFFE r) . ANO ST REE PO. BO% MAILING AOINiESS: RF DIF R f IN C MM I TEPS) CITY ST AJ E� ZIP COyE fjll CITY �� / �r , SIAIE ZIPCWE A �AII�TL Attach additional information on appropriately labeled continuation sheets. III Controlled Committee Is t s committee controlled by an officeholder. candidate, or state measure proponent? (See definition and important information on reverse.) Is (Complete the following) ❑ No • If this committee is controlled by an officeholder or a candidate, list the name of the controlling officeholder or candidate, the elective office sought or held, and district number, if any. If this committee is controlled by more than one candidate, list the name of each controlling candidate. • if this committee is controlled by a slate measure proponent, list the name of the stale measure proponent. If this committee is controlled by more than one suite measure proponent, list the name of each state measure proponent. • If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. Attach additional infornuaion on appropriately labeled continuation sheets. You must complete the Verification on Page 2. FOR INFORMATION REOUIRED TO BE PROVIDED TO YOU PURSUANT TO D IE ITT ORMAI ION PRACTICES ACT 01: 1977, SEE INF:Q73MAIJON MANUAL NCAMPAIGN DISCLOSUIIEPNOVISIONS.Of 3I IE L'OLIIICAL.IIEEOIIM AC I Stale of California Fair Political Practices Commission STATEMENTOI;ORGANIZATION ,I Statement of Organization - Type O' Print t "Ink. r Recipient Committee • SEE INSTRUCTIONS ON REVERSE Attach additional infornwtion on appropriately labeled continuation sheets. Page 2 NAME OF COMMITTEE: IV Broad Based Committee (See definition and inrportanrinfortnation on reverse) If this is a broad based committee and wishes to make contributions to candidates in excess of the $2 contribution limit in connection with a special election, check the box below and enter the date on or before which the committee qualified as a broad based committee. (If the comndttee is not a broad based conuninee, or does not wish to make contributions in excess of the $2,500 limit, do not complete this section.) ❑ Check box if this is a broad based committee. Enter the date on or before which the committee qualified as a broad based committee: (Aronth, Day, rear) � V Sponsored Committee Is this a sponsored committee? ❑ Yes ❑ No (See instructions on reverse for definitions and rules regarding a sponsored committee's mmne.) If yes, provide name and address of sponsor. If the committee has more than one sponsor, provide names and addresses on appropriately labeled attachment. NAME OF SPONSOR. ADDRESS OF SPONSOR: - NO. AND STREET CITY STATE ZIPCOOE V I Primarily Formed Committee If primarily formed to support or oppose specific candidates or measures, list specific candidates or measures below: CANDIDATE'S OFFICE SOUGHT OR I4ELD OR MEASURE'S JURISDICTION CHECK ONE CANDIDATE'S NAME OR MEASURE'S FULL TITLE (INCLUDE BALLOT NO. OR LETTER) (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) �owr awoer ' ' n+rnoar arrow ' VII Committee's Primary Activity it Not Primarily Formed If not supporting or opposing specific candidates or measures, see instructions on reverse and check ONE box to indicate if this is a: ❑ CITY Comm or ❑ COUNT Committee or ❑ STATE Committee _ PROVIDE BRIEF DESCRIPTION OF ACINIIY - ' VIIIDisposition Surplus Funds You must specify what d will be made of surplus funds i n the event of termination. IX Verification 1 have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is complete. 1 certify under penalty of perjury under the I ws of the Slate of California thatthat the�is true Correct. Executed on 7 At By / DATE NY AND SIA G URE F UII Executed On I OAE CIIYANUStAIE Y SIGNAIUnEOF fIOl1.ING OFr 1ROI DEn,C DA rE, On S1AIE MFASUnE RiIXaNENr Executed on At By DATE CITY AND SIAI E SIGNAI URE OF CON I FM I ING 011 IC E 101 DER, CANDIDA I E, pl SIAIL MEASURE I'ROI V NEN I i Executed on CI At By IMIE IY ANU SINE SILNAIUIIE OF CONII101.I IN4011 N,r1101 D1:11, CANUIIMI1, 011 SIAII: MI. 51111E IMIOI'UNPNI °23042 STATE MENT OF ORGANIZATION Statement of Organization Type or Print In ink. Amendment Dale Stamp 7AFor Ty Recipient Committee C) Cl Check box if an Amendment T IE v I, ` (Govemmcnitide Sections841OI- 84103) y)O and enter I.D.number. D rh Q nfr= f I V�— se Only S INSTRUCTIONS ON REVERSE EIVED e Q Dat ualified as OCT 0 5 199 FILED 111 Secretary of Stale copy of this form with: ails form Pith ble, ❑le one copy of Committee:(Monlh,Day,Yeer) ? Seertyaryp( f ate Political Reform Division The city or county officer, if airy, who B Cafifornia P.O. Box 1467 receives the conunince's original 8 1992 Sacramento, CA 95812 -1467 campaign disclosure statements. f CRmck box if not yet qualified MARL JG 1 Committee Information 11 Treasurer and Other Principal ONicers ryofStatg NAME OF COMMITTEE: NAME OF 1REAWNt R: 6 illee fO /CP- e'/T(' f ES S Q� ��c/R ✓DE MAILING ADDRESS: (IF DIFFERENT TITAN COMMIT ZEES) ADDRESS 01: COMMIT ICE: (NOT P O. BOX) NO. AN / E °� IM � TREET cou!jE,Y: fJ CITY a - STATE ZIP DE AREA C IME PI ]ONE y /�G.? �G/(� {✓ � 1111oIQt,15 CITY STATE ZIP CODE NAME AND POSITION OF OI I RPRINCIPAL OFFICER($) MAILING N)I)IIESSNIF DIErERENI) NO AND SIREET OR PO. BOX MAILING ADDRESS: (IF DIFFERENT DEAN COMMITTEES) CITY STATE ZIP ODE AREACODEIPIIONENOMBfR CITY Sf IE ZIPQODE AREA CODE /DAYI IME PI TONE Attach additional information on appropriately labeled continuation sheets. III Controlled Committee Is this committee controlled by an officeholder, candidate, or state measure proponent? (See definition and important information on reverse.) rig Yes (Complete the following) ❑ No • If this committee is controlled by an officeholder cr a cmtdidale, list the name of the controlling officeholder or candidate, the elective office sought or held, and dislfict number, if any. If this committee is controlled by more Ulan one candidate, list the name of each controlling candidate. • If this committee is controlled by a state measure proponent, list the name of the slate measure proponent. If this committee is controlled by more than one state measure proponent, list the name of each stale measure proponent. • If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. Attach additional information on appropriately labeled continuation sheets. You must complete the Verification on Page 2. Von INPOTIMAIION REOUIRED TO BE PROVIDED TO YOU PURSUANT TO 11 IF INFORMATION PRACIICES ACT OF 1971, SEE INEOIIMAIION.MANUAL-ON CAMPAIGN. DISCLOSURE-PROVI $IONS- OFInE. l201-111CALnEEORM AGl. State of California Fair Political Practices Commission STA'I'EMEN'1' Oh ORGANIZATION Statement of Organization Type or Print in Ink. Recipient Committee " • � � SEE INSTRUCTIONS ON nEVERSE Attach additional information on appropriately labeled continuation sheets. Page 2 ' NAME OF COMMITTEE: IV Broad Based Committee (See definition and important information on reverse) If this is a broad based committee and wishes to make contributions to candidates in excess of die $2,500 contribution limit in connection with a special election, check the box below and enter the date on or before which the committee qualified as a broad based committee. (If the committee is not a broad based committee, or does not wish to make contributions in excess of the $2,500 limit, do not complete this section.) ❑ Check box if this is a broad based committee. Enter the dale on or before which the committee qualified as a broad based committee: (At."m, Day, year) V Sponsored Committee Is this a sponsored committee? ❑ Yes ❑ No (See instructions on reverse for definitions and odes regarding a sponsored committee's name.) If yes, provide name and address of sponsor. If the committee has more than one sponsor, provide names and addresses on appropriately labeled attachment. NAME OF SPONSOR ADDRESS OF SPONSOR. NO AND STREET CITY STATE ZIPCODE V I Primarily Formed Committee If primarily formed to support or oppose specific candidates or measures, list specific candidates or measures below: CANDIDATE'S OFFICE SOUGHT OR HELD OR MEASURE'S JURISDICTION CHECK ONE CANDIDATE'S NAME OR MEASURE'S FULL TITLE (INCLUDE BALLOT NO. OR LETTER) (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) YI. .T OIro.. VII Committee's Primary Activity if Not Primarily Formed If not supporting or opposing specific candidates or measures, see instructions on reverse and check ONE box to indicate if this is a: ❑ CITY Committe or O COUNTY Committee or ❑ STATE Committee PIxpVIUE BREF UESCRIPIION OP AC INIIY VIII Disposit of Surplus Fu nds You must spec w d w be ma o s urpl us funds in t e of termination. IX Verification 1 have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is We and complete. I certify under penally of perjury under the laws of the State of California that the foregoing is We and correct. Executed on �� / At �/' /d�'C'u�o , C� By DliIE CIiYANDSIAIE SI AT RE F SUITE Gn 7 Executed on ' S / l/ At �� ✓VLq BY DATE GIIYANI)SIAIE SIG IU OF CONII OIIIN .OF�CEIIOI.OF. R�6ANUIU IE, OII SIAIr MfASU11E NIOI`ONFNI Executed on At By DATE CITY ANO STATE SIGNAIUIIE OF CONInULLING OFfICE1IOI DEII, CANDIDATE. 011 S IATE MEASURE T'ROItlNLNT Executed on AI Ry DATE CI I YAND SIAIF SIGNAIUIIE OF CONIIIOLI ING OFFICEI101. DLD, CANDIDATE, O11 STATE MFASUIIE PROPONENI S'I'A'I'rmEN'r OF ORGANIZA'nON • - Statement of Organization Type or Print in Ink. Amendment Dale Slamp , I mm Recipient Committee CI Chcck Wx if an Amendment HI . (Goveenl Code Section, 84101- 84103) and enter I.D. numhcr. D E� rl"+— �nq I L r �5 V A Fol Official Use Only SEE I ON REVERSE 0 Pile original and one copy of this form with: And, If appllcabie, file one copy of Dale qualified as OCT T (j J 1992 Secretary of State this form with: Committee: (Moral, Day, Year) Political Reform Division The city or county officer, if any, who B P.O. Box 1467 receives the committee's original _ Sacramento, CA 95812 -1467 campaign disclosure statements. Ureck box if not yet qualified 1 Committee Information 11 Treasurer and Other Principal Officers NAME OF COMMITTEE: NAME OF HIEASUIT MAILINGADDRESS (IF DIFFERENT TIM COMMIT IEE'S) ADURESSOF COMMITTEE (NOT P.O. BOX) NO. AN STREET COuIj1,Y: CITY - SIAIE ZIPC E AREA P O V FJ DAYl IME III ONE .V ��w�ui�� CITY SIAIE ZIPCODE NAME. ANU POSITION OF O]II RNiINCIPAL OF PIC? 1 C��' MAILINGaUURESS:(IF DIFFERENT) NO AND STREET OR P. O. BOX MAIUNGAWHESS, (IFDIFFERENTTIIMCOMMIIIEES) .doe �y�isK ei rY SIAIE ZIP ODE MCA CODE/F1 ZONE NUMBEH CITY SI TE ZIP CODE AREA CODEIDAYNME PHONE �� %iii ✓rr c � u (9 f L y/ Attach additional information on appropriately labeled continuation sheets. III Controlled Committee Is this committee controlled by an officeholder, candidate, or slate measure proponent? (See definition and important information on reverse.) 9 (Complete the following) ❑ No • If this committee is controlled by an officeholder or a candidate, list die name of die controlling officeholder or candidate, the elective office sought or held, and district number, if any. If this committee is controlled by more than one candidate, list the name of each controlling candidate. • If this committee is controlled by a state measure proponent, list the name of the slate measure proponent. If this committee is controlled by more than one slate measure • proponent, list the name of each state measure proponent. • If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. l� Via/ 0�u/Jd� Attach additional informwtion on appropriately labeled continuation sheets. You must complete the Verification on Page 2. FOR INFORMATION REOUIRED TO BE PROVIDED 10 YOU PURSUANT TO THE INFOFIMATION T'IIACTICES ACT OF 1911, SEE INFORMATION MANUAL CAMPAIG N,DISCLQSUnE. PRQVISIQN OF THE POI ITICAI R EFQUM - ACT Slate of California Fair Political Practices Commission STATEMENT OF ORGANIZATION ' Statement of Organization Type or Print in Ink. r Recipient Committee " • ' SEE INSTRUCTIONS ONnEVESE Attach additional inforouttion on appropriately labeled continuation sheets. Page 2 NAME OF COMMITTEE: IV Broad Based Co mmittee (See definition and important information on reverse) If this is a broad based committee and wishes to make contributions to candidates in excess of die $2,500 contribution limit in connection with a special election, check the box below and enter die dale on or before which the committee qualified as a broad based committee. (If the committee is not a broad based committee, or does not wish to nmke contributions in excess of the $2,500 limil, do not complete this section.) Ll Check box if this is a broad based committee. Enter the dale on or before which the committee qualified as a broad based committee: (Afunth, Day, year) V Sponsored Committee Is this a sponsored committee? ❑ Yes ❑ No (See instructions on reverse for definitions and rules regarding a sponsored committee's name.) If yes, provide name and address of sponsor. If die committee has more than one sponsor, provide names and addresses on appropriately labeled attachment. NAME OF SPONSOIP. . ADDRESS OF SPONSOR NO AND STIELI CITY STATE ZIPCODE V I Primarily Formed Committee If primarily formed to support or oppose specific candidates or measures, list specific candidates or measures below: CANDIDATE'S OFFICE SOUGHT OR HELD OR MEASURE'S JURISDICTION CHECK ONE CANDIDATE'S NAME OR MEASURES FULL TITLE (INCLUDE BALLOT NO. OR LETTER) (INCLUDE DISTRICT NO., CITY OR COUNTY. AS APPLICABLE) wr.owr arro.r VII Committee's Primary Activity if Not Primarily Formed If not supporting or opposing specific candidates or measures, see instructions on reverse and check ' ONE bo x t o indicate if (Iri i a: ❑ CITY Committee or ❑ COUNTY Committee or ❑ STATE Committee ' PnOVIDE BRIEF DESCRIPI ION OF ACTLAITY l VIII Disposition of Su Funds Yo u must spec ify what disposition will be Trade of surplus funds in the event of termin . IX Verification I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is we and complete. I certify under penalty of perjury under the laws of th State of California that the ` foregoing is we and correct. / S� / At /vl�� /0 7 B /1 OAIE CRYANDS / y 51 AT RE F. F SUIIF. Executed on 1 Executed on ip ' S l �/ At / / / ✓�� /9 I By DATE CITYANDSIAT SIG / 1 I OF UUERRLFLI OF / EI101DEIE ANDIDAIE. or STATE MEASURE PROPONENT Executed on AI By DATE CITYANO STATE SIGN IUIIE OF CONIROI. I ING Of I CENOLDER, CANDIDATE. OF STATE MEASURE PROPONENT Executed on AT By DATE CITY ANU SIAIIi SIGNAIDRE DI'CONIHOLIING 011 ICE1101 DER, CANIND IE, Oil STATE MI ASUIIE 11101VNIiN1