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Recipient Committee <br />Campaign Statement <br />Cover Page <br />SEE INSTRUCTIONS ON REVERSE <br />Statement covers period <br />from V' t - 1% <br />through (' -3y- L V <br />1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. <br />XOfficeholder, Candidate Controlled Committee <br />O State Candidate Election Committee <br />O Recall <br />tW COMO* Pat 5) <br />❑ General Purpose Commsttee <br />O Sponsored <br />O Small Contributor Committee <br />O Political Party/Central Committee <br />3. Committee Information <br />4. <br />❑ Primarily Formed Ballot Measure <br />Committee <br />O Controlled <br />O Sponsored <br />(AJ- Complete Pat 6) <br />❑ Primarily Formed Candidate/ <br />Officeholder Committee <br />(Also Complete Pat 7) <br />I.D. NUMBER <br />M.WTTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) <br />SS R%A -T% (>VA �t S For�Ye-016 C:r,)r%� Qoct C:A , 2v"W <br />COVER PAGE <br />Date Stamp <br />REcENED <br />Date of election if applicable: Page of <br />(Month, Day, Year) JUL 17 2018 For Official Use only <br />IFTHE <br />'Ll- %- 2v\g' Calf vas <br />2. Ty?f Statement: <br />Rr Preelection Statement ❑ Quarterly Statement <br />❑ Semi-annual Statement ❑ Special Odd -Year Report <br />❑ Termination Statement <br />(Also file a Form 410 Termination) <br />❑ Amendment (Explain below) <br />Treasurer(s) <br />NAME OF TREASURER <br />CITY STATE ZIP CODE AREA COOE/PHONE <br />OPTIONAL: FAX/ E-MAIL ADDRESS <br />MAILING ADDRESS <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />OPTIONAL: FAX/ E-MAIL ADDRESS <br />Verification <br />I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained <br />certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. <br />/J I� <br />Executed onf� / ' By <br />Date <br />� <br />Executed on. 1 �1— `" l By <br />Date �. <br />Executed on <br />Date <br />Executed on <br />Date <br />the attached schedules is true and complete. I <br />By <br />Signature of Controlling Officeholder, Candidate, State Measure Proponent <br />By <br />Signature of Controlling Officeholder, Candidate, State Measure-ProponenT <br />FPPC Form 460 (Jan/2016) <br />FPPC Advice: advice[alfppc (866/275-3772) <br /> <br />