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SHORTFORM
Officeholder and Candidate 'type or Print InInk Dalo Stamp r
Campaign Statement — Short Form . 1
(Govalunent Cale Section 84206) - C ,-1 ��
( /] A For OlGcial Uso Only
For %sc by officeholders and candidates who do not have a controlled committee and who do not anticipate receiving
$1000 or more in contributions and do not anticipate spending $1000 or more during the entire calendar year.
Officeholders whose salary is less than $100 per month and judges who have a controlled committee may use this fo JAN 31 1994
under certain circumstances. See the appropriate Information Manual on CamRaign Disclosure Provisions of the
Political Reform Act (Manual A) for further information.
Stat e m ent covers Calendar Year 19A.
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Officeholder or Candidate Information 11 Information on Office Held or Sought
MAME_7 FFI7Oq OFFICE NEI Qg T /
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ESIDFNRALOR USINESSAWRESS: (NO. ANO IREET) JURISDICPONQ C / DISTRICT NUMBERRFAWLICAIII E)
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CITY �� /� SUTE P CO� 6TIE OF EL Cll N(MONTILDAY. YEAR) )IF MIi 1CARl E)
AREA OTXAJAVIIME,1 10 N MDm
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III Committee Information
List all committees of which you have knowledge that are primarily formed to receive contributions or to make expenditures on beta(( of your candidacy.
COMMITTEE NAME AND I.D. NUMBER COMMITTEE ADDRESS NAME OF TREASURER
IV Verification
1 declare under penalty of perjury that to the best of my knowledge, I anticipate that I will receive less than $1000 and that 1 will spend less than $1000 during the calendar year
and that 1 have used all reasonable diligence in preparing this statement. l certify under penalty of perjury under the laws of the State of California that the foregoing is true and
correct.
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Executed on At B y
DAI GIYANDSIATE SIGNAI IIE OF OFFIqPJ6L Dun OR CANDIDATE
FOR INFORMATION REQUIRED TO BE PROVIDED IO YOU PURSUANT TO TI IE INFORMATION PRACTICES ACT OF 1977, SEE INFORMATION MANUAI DNCAMPAICI DISCIOCI PROVISIONS OF TRF POLITICAI RFFORMACT.
Stale of California Fair Political Practices Commission.
ofJceholder and Candidate Type or print in ink. SHORTFORM
Campaign Statement — Short Form Date stamp
(Government Code Section 04206) \`!I 1
i j' i= L� (1 V L� For Official Use Only
For use by officeholders and candidates who do not have a controlled committee and who do not anticipate D
receiving $1,000 or more in contributions and do not anticipate spending $1,000 or more during the
calendar year. Officeholders whose salary is less than $100 per month and judges who have a controlled V AUG 0 1 1994
committee may use this form under certain circumstances. Seethe Information Manual on Cam ai n
Disclosure Provisions of the Political Reform Act for Elected Officeholders, Cand an T elr Controlled
Committees or further information.
I y
1 Statement Covers Calendar Year 19
1 1 Officeholder or CandidAte Information III Information on Office Sought or Held
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOU � HT OR HELD
UAld e5 ('011N ' /
RESIDENTIAL OR BUSINESS ADDRESS (NO. AND STREET) )URISDICTIQN(LOCATION) �F gppICABLE
Zf Sid ?' S¢ * Za� 7 Ae evk
CITY TATE ZIP CODE DATE OF ELECTION (MONTH, DAY, YEAR) (IF APPLICABLE)
AREA CODE/DAYTIME PHONE NUMBER l( �� ' 7 � ✓ N
IV Committee Information
List all committees of which you have knowledge that are primarily formed to receive contributions or to make expenditures on behalf of your candidacy.
CO MMITTEE M NUMBER COMMITTEE ADDRESS NAME OF TREASURER
-� NoeU
V Verification
I declare under penalty of perjury that to the best of my knowledge, I anticipate that I will receive less than $1,000 and that I will spend less than $ 1,000 during
the calendar year and that I have used all reasonable diligence in preparing this statement. I certify under penalty of perjury under the laws of the State of
California that the foregoin / 9 is true and correct.
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Executed on / At �r - g
DATE CI ND STATE s16NATURE OF FICIENOLDE11,06 CANDIDATE
FOR INFORMATION REQUIRED TO If PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT Or 1977. SEE INFORMATION MANUAL ON CAMPAIGN DISCLOSURE PROVISIONS OF THE POUtKAL REFORM ACT
State of California Fair pontical practices Commission