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Recipient Committee <br />Campaign Statement <br />Cover Page <br />Statement covers period <br />from 1-� - Z 7. <br />SEE INSTRUCTIONS ON REVERSE <br />I through <br />1. Type of Recipient Committee: All Committees— Complete Parts 1, 2, 3, and 4. <br />�(-Officeholderi Candidate Controlled Committee <br />❑ Primarily Formed Ballot Measure <br />0 State Candidate Election Committee <br />Committee <br />O Recall <br />0 Controlled <br />(Also Complete Parts) <br />O Sponsored <br />(Also Complete Part 6) <br />❑ General Purpose Committee <br />O <br />❑ Primarily <br />Sponsored <br />Formed Candidate/ <br />O Small Contributor Committee <br />Officeholder Committee <br />0 Political Party/Central Committee- - <br />(Also Complete Peg n <br />3. Committee Information . I I.D. NUMBER <br />COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) <br />M an.ir e s 40Y C0 I +0 1rL CI N CovnQ0 2022 <br />STREETADDRESS (NO P.O. BOX) <br />?.' <br />CITY STATE ZIP CODE AREA CODE/PHONE <br /> <br /> ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX <br />Sc> <br /> STATE ZIP CODE AREA CODE/PHONE <br />COVER PAGE <br />Date Stamp CALIFORNIA <br />I�ECEIVE� O <br />RM <br />Date of election if applicable: Page 1- of <br />(Month, Day, Year) OCT 2 0 2022 For Official Use <br />it - $- 202?, OFFICE OF THE <br />CITY CLERK <br />2. Type of Statement: <br />iK Preelection Statement ❑ Quarterly Statement <br />❑ Semi-annual Statement ❑ Special Odd -Year Report <br />❑ Termination Statement <br />(Also file a Form 410 Termination) <br />❑ Amendment (Explain below) <br />Treasurer(s) <br />NAME OF TREASURER <br />Padl6► Mon�-Qyn <br />MAILING ADDRESS <br />13 <br /> STATEZIP CODE AREA CODE/PHONE <br />Coli-on ( <br /> IF ANY <br />al <br />MAILING ADDRESS <br />CITY STATE ZIP CODE AREA CODEIPHONE <br />OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/E-MAIL ADDRESS <br />G01+o yL 3 <br /> <br /> used all reasonable diligence in preparing and reviewing this statement and to the <br />certify under penalty of pjedury under the laws of the State of California that the foregoing <br />Executed on ! r 2' p e Z By/ <br />Executed on <br />Date <br />Executed on <br />Date <br />r <br />Executed on <br />Date <br />By <br />my knowledge the information contained herein and in the attached schedules is true and complete. I <br />or <br />or <br />By <br />Signature of Controlling Officeholder, Candidate, State Measure Proponent <br />By <br />Signature of Controlling Officeholder, Candidate, State Measure Proponent <br />FPPC Form 460 (Jan/2016)) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />