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HomeMy WebLinkAboutBENHAM SUE 405 04/11/01 mendment to Campaign Disclosure Statement Type or print in ink This form must be used to amend statements filed pursuent to Government Code Sections 84200-8421 {L$. and m u~t be filed with ell fdmgoff,cerswhorece~vedthestatementbeingamended NOTE: Oo not use this form to emend e Stetement of Orgenizetion. Form rite infmmation required in Pa rt I must (orreslx~d to the information provided on the cempolgn ~tetement being emended. I Name of Filer (See important info~mationonreverse.) NAME OF FILER I I.D. NUMBER I 0.0t~vHTTEE ~'o EL~_CT SUE Br~Nffh~ ia~t~ CITY STATE AREA CODE/DAYTIME PHONE NUMBER NAME OF TREASURER IF RECIPIENT COMMITTEE )DRESS OF TREASURE R: (IF APPLICA$LE) oty STATE AREA CODE~AYT~ME PHONE NUMBER (NO. AND STREET) ZIP CODE ZiP CODE q33© I III Verification (SeeimDortantlnformationonreverse.) ~, Date Stamp ,., 17 '" II Amendment Information AMENDMENT For Official Use Only A. The following information amends campaign disclosure statement, Form No. 4.~ executedon I';~O'c)I fortheperiod 10/2~')00 through 1o~/ B. The amended information affects items on the: [] Cov~r Page [] Allocation Pege [] Summery ~ ~hedu~s) ~ ~ Pi~s) C. De~ri~ the chang~ ~iow. I~clude i~ detail alt informatio~ you wis~ ~come a pa~ of your official campaign statement. Please a~ach a cover ~ge, summary page ancot appropriate schedule(s) to this Form 405 if necessary for clarifi~tion. Include additional info~mation on appropri- ately la.led continuation sheets. (Numar of sheets attached 1 .) Executed on At By Executed on At By State of California Fair Political Prectices Commission Schedu;e A T~p, or print In ink. SCHEDULE A Monetary Contributions Received ~,,moun~mayoereun~en S~,:c-,T,;r,:cnversperiod I ~ ~ NAMESEE 'NSTRUC~ONS ON REVERSEoF RLER ~r°ugh'l' ~' /DO I 1;7::~Of ~ DATE FU~ NAME, MAILING ADORESS AND ZIP CODE OF CONTRIB~OR ~ IF AN IN.DUAL, INTER AMOUNT CUMU~TIVE TO OA~ CUMU~TIVE TO DA~ RECEIVED 0F ~EE. ~LSO ENTER tO. ~R) CONTRIB~OR ~CUPA~ AND EMPLOYER RECEIVED ~IS CALENDAR YEAR O~ER COnE * (IF SE~.EM~EO. ENTER N~ PER~D (JAN. ~ - DEC. 3 ~ ) (IF Ap~ICABLE) l o/~ioo~ ~, ~ L~uu ~ DCOM Itfi/ee ~ OCOM SUBTOTAL Schedule A Summary 1. Amount received this period - contributions of $100 or more. (Include all Schedule A subtotals.) ....................................................................................................... $ 2. Amount received this period - unitemized contributions of less than $100 ......................................... $ 3. Tolal monetary conlributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ................... TOTAL $ FPPC Form 460 (8/9g) For Technical Assistance: 916/822-5660