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Recipient Committee <br />Campaign Statement <br />Cover Page - Part 2 <br />5. Officeholder or Candidate Controlled Committee <br />Type or print in ink. <br />NAME OF OFFICEHOLDER OR CANDIDATE <br />OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) <br />RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP <br />Related Committees Not Included in this Statement: List any committees <br />not included in this statement that are controlled by you or are primarily formed to receive <br />contributions or make expenditures on behalf of your candidacy. <br />COMMITTEE NAME I.D. NUMBER <br />NAME OF TREASURER CONTROLLED COMMITTEE? <br />❑ YES ❑ NO <br />COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />COMMITTEE NAME I.D. NUMBER <br />NAME OF TREASURER CONTROLLED COMMITTEE? <br />❑ YES ❑ NO <br />COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />COVER PAGE - PART 2 <br />I Page 2 of 16 <br />6. Primarily Formed Ballot Measure Committee <br />NAME OF BALLOT MEASURE <br />BALLOT NO. OR LETTER I JURISDICTION I F-1 SUPPORT <br />❑ OPPOSE <br />Identify the controlling officeholder, candidate, or state measure proponent, if any. <br />NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT <br />OFFICE SOUGHT OR HELD I DISTRICT NO. IF ANY <br />7. Primarily Formed Candidate/Officeholder Committee List names of <br />officeholder(s) or candidate(s) for which this committee is primarily formed. <br />NAME OF OFFICEHOLDER OR CANDIDATE <br />OFFICE SOUGHT OR HELD <br />❑ SUPPORT <br />❑ OPPOSE <br />NAME OF OFFICEHOLDER OR CANDIDATE <br />OFFICE SOUGHT OR HELD <br />❑ SUPPORT <br />❑ OPPOSE <br />NAME OF OFFICEHOLDER OR CANDIDATE <br />OFFICE SOUGHT OR HELD <br />❑ SUPPORT <br />❑ OPPOSE <br />NAME OF OFFICEHOLDER OR CANDIDATE <br />OFFICE SOUGHT OR HELD <br />❑ SUPPORT <br />❑ OPPOSE <br />Attach continuation sheets if necessary <br />FPPC Form 460 (January/05) <br />FPPC Toll-Free Helpline: 8661ASK-FPPC (8661275-3772) <br />State of California <br />