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Recipient Committee <br />Campaign Statement - <br />Cover Fuge <br />SEE INSTRUCTIONS ON REVERSE <br />Statement covers period <br />7 <br />from ! — t— ` ji <br />through <br />(l_-IZ- \g <br />1. Type of Recipient Committee: All Committees —Complete Parts 1, 2, 3, and 4. <br />Officeholder, Candidate Controlled Committee <br />0 State Candidate Election Committee <br />0 Recall <br />(Also Complete Part 5) <br />❑ General Purpose Committee <br />0 Sponsored <br />0 Small Contributor Committee <br />0 Political Party/Central Committee <br />3. Committee Information <br />COMMITTEE NAME {OR CANDIDATE'S NAME IF NO <br />❑ Primarily Formed Ballot Measure <br />Committee <br />0 Controlled <br />0 Sponsored <br />(Also Complete Part 6) <br />❑ Primarily Formed Candidate/ <br />Officeholder Committee <br />(Also Complete Part 7) <br />I.D. NUMBER <br />ISG I S00 <br />Seth_ '10VV as 7OY-V�11ye-Z Cou v1c;1 z 2_(D� g <br />Date of election if applicable: <br />(Month, Day, Year) <br />i% — ("- 201,9 <br />Date Stamp <br />ZECEIVEn <br />'EP 2 0 2018 <br />OFFICE OF THE <br />CffY CLERK <br />2. Type of Statement: <br />L Preelection Statement <br />❑ Semi-annual Statement <br />❑ Termination Statement <br />(Also file a Form 410 Termination) <br />❑ Amendment (Explain below) <br />Treasurer(s) <br />COVER PAGE <br />Page _ of - 2, I <br />i <br />I <br />For Official Use Only <br />❑ Quarterly Statement <br />❑ Special Odd -Year Report <br />MAILING ADDRESS <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />OPTIONAL: FAX) E-MAIL ADDRESS <br />4. Verification <br />I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herer� and i. a attached schedules is true and complete. <br />certify under penalty of peri ,under laws of the State of California that the foregoing S t and correct. <br />Executed on By <br />Slgnat�e.aP or Asarat�i hevasuYer <br />Executed on . ■ — 2-U \ S — <br />nate <br />Executed on <br />Date <br />E xeculed on <br />Date <br />By <br />or <br />By <br />Signature of Controlling Officeholder, Candidate, State Measure Proponene <br />By <br />Signature of Controlling OTficeholdar, Candidata, Slain Measure Proponent <br />FPPC Form 460 (lap <br />FPPC Advice: advice@fppc.ra.pnv rte_ <br />