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Johnson 460
R ecipient Commi COVER PACE Type or print in Campaign Statement ink. Date Stamp Cove Page A Government Code Sections 84200. 84215.5 ilk of Statement ment cvvers period Date of :.e if app[ica 9 loath, Day, Y ear} r Gffcial Use only f ro m P.A SEE INSTRUCTIONS ON RELfERSE through let, ;p 'A g T e of Rec lent C +I'JCTrt"1ltte Committees -Gam lets Parts 3 and 4 �M'........ p x. ..x.. x'. �y ��p�, i.li alder n i Officeh Ca d date Controlled Committee Ej Primaril Formed:Ballot Illfeasure Y Preelection Statement C,}uarterly Statement 0 State Candidate Election Committee Committee 0 Recall O Controlled Semi- annual Statement Special Odd Year Report (Atsa C Part 5 0 Sponsored Termination Statement 0 Supplemental Preelection Also file a Form irrn ination 410 Te Statement` Attach Form 495 �1� Complfe'ert6 General Purpose Committee Amendment (Explain below} Sponsored F-] Primaril Farmed Candidatef Y Srraff Contributor Committee D cehvider `Cvrnmittee Rl C so a lets Part 7 Political:Part ICentral Committee P C� Y 3. Corinnittee Infvrlation I.D. NUMBER Treasurers COMMITTEE. NAME JOR CANDIDATE'S NAME IF NO COMMITTEE} NAME OF TREASURER 6 /Y a STREET ADDRESSN0 P.O. BOXY CITY STATE ZIP CODE AREA COPE/PHON E CITY STATE ZIP CODE AREA �C]DEfPHC3NE NAME QF A5Sl5TANT TREASURER IF ANY ';4 y 41 MAILING ADDRESS (IF. DIFFERENT) NO. AND STREET OR P_O; BOX A L( CITY STATE ZIP CODE AREA CODE/PHONE CITE' STATE ZIP CODE AREA CODEIPI-IONE OPTIONAL; FAX E -MAIL ADDRESS OPTIONAL: FAX E-MAIL ADDRESS 4 Ve rification. I �ave.used.all reasonable dill ence in and reviewing this statement and to the hest of my. knowledge 9 preparing 9 the irlfarmativn contained herein and in the`attached schedules is true and cvm lets. I certify P under penalty of perjury underthe laws ofthe State.of California that the f+oregving i tr ue and correct: Ji Date Signs ira of Controlling Officeholder, 0andidate, S measurV roponent or Responsible Officer of Sponsor Executed on By Date Signature of Controli' Candid te, State Measure Proponent Execut ed an By Date Signature of fficeholder, Candidate State Measure Proponent g p FPPC Form 460 {Januaryt05} FPP+C Toll -Free elpi ne. 866 ASK -FPPC (8661275- 3712) State of :Califarr is Reci Committ C St C P Type or print in ink. Page of 6. Pri.ma.i Y F o rm ed Ballot m eas ure C NAME OF BALLOT MEASURE BALLOT NO. OR LETTER SUPPORT OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER,. CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY NAME OF TREASURER CONTROLLED COMMITTEE? 1 11 101 iy. ornned Gand1dateltJ111ceho1der Co mmmee List names of o ficeholder(s .can.didate(s) for .w.hich :this committee is rimaril formed: Y YES NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) NAME OF OFFICEHOLDER OR CANDIDATE. OFFICE SOUGHT OR HELD El SUPPORT OPPOSE CITY STATE ZIP CODE AREA CODE/PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT R O HELD SUPPORT OPPOSE COMMITTEE NAME I.D. NUMBER NAME F F O OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT OPPOSE NAME OFTREASURER CONTROLLED CUIL1lIVI[TTEE? NAME.OF :OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 YES NO SUPPORT OPPOSE COMMITTEE ADDRESS STREET ADDRESS (NO P_0. BOX) Attach c ©rttita€ atron sh eet s if necessary CITY STATE ZIP CODE AREA CODE/PHONE FPPC. Form 460 (January/0.5) FPPC Toll- Free :Helplina::866IASK -FPPC (8661275.3772) Stake ©f California