Officeholder and Candidate

Campaign Statement
Short Form
Government Code Section 84206

Type or print in Ink

I I T

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Date of election if applicable Month Day Year

I Amendment Explain Below t I JAN 27 Ph 3 32

1 Statement Covers Calendar Year 2010

2 Officeholder or Candidate Information

3 Office SouagW or Held

OFFICE SOUGHT OR HELD

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STREET ADDRESS 16 T E V
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ZIP CODE

JURISDICTION LOCATION

aJQ IY
CITY

G I
STATE

IFAPPUCABLE

7b
AREA CODE PHONE NUMBER DAYTIME

909 10 aI z
4 Committee Information

List all committees of which you have knowledge that are primarily formed to receive contributions or to make expenditures on behalf of your candidacy NAME OF TREASURER COMMITTEE ADDRESS E MITT AME COM N AND I NUMBER D I 1 a8 avH Eia a 70 r
Idd
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77

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Verification

I declare under penalty of perjury that to the best of my knowledge I anticipate that I will receive less than 1 and that I will spend less than 1 during the 000 000 calendar year and that I have used all reasonable diligence in preparing this statement I certify under penalty of perjury under the laws of the State of California
that the foregoing is true and correct
Exewted on
n

7
DATE

By
SIGNANNE OF

FPPC Form 4701470 Supplement January 08 FPPC Tall Free Helpllne 866ASKFPPC 866 3772 275
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