HomeMy WebLinkAboutBTC 07/01/01 - 09/30/01 AMEND ecipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEEINSTRUCTIONS ON REVERSE
Type or print in ink.
Statement covers period
,rom I-Ct
COVE~ PAGE
Date Stamp
Dste o, e~ectio, if 10 ~t 3:
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I
(Month, Day, Year) ' Page
..... !~ ~.~.~ \O. For Official Use Only
1. Type of Recipient Committee: A, Committees - Complete Parts I, 2, 3, and 4.
[] Officeholder, Candidate Controlled Committee O State Candidate Election Committee
O Recall
General Purpose Committee
~. Sponsored
C) Small Contributor Committee
C) Political Party/Centra~ Committee
[] Ballot Measure Committee O Pdma~ly Formed
O Controlled
O Sponsored
(Also Comp~te Pa~1 $)
[] Primarily Formed Candidate/
Officeholder Committee
(Also Cc~p~ete Pat17)
3. Committee Information
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
2. Type of Statement:
[] Preetection Statement [] Quarterly Statement
[] Semi-annuaIStatement [] Special Odd-Year Report
[] Termination Statement [] Supplemental Preelection
[~ Amendment (Explain below) Statement - Attach Form 495
Tre~su~r(s]
N OF TREA URER
NAME ~F-ASSISTANT TREASURER, IF ~Y
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
CiTY STATE ZIP CODE AREA CODE(PHONE
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the informalion contained herein and in the attached schedules is true and complete. I
certify under penalty of perjury under the laws of the State of California that the forego' correct.
Executed on Dy
Executed on By
Executed on By FPPC Form 460 (June/01)