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Denise Timney Ranish for Mayor 460Recipient Committee Campaign Statement Cover Page Type or print in ink. (Government Code Sections 84200-84216.5) Statement covers period from __________ _ SEE INSTRUCTIONS ON REVERSE through ________ _ 1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4. D Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Complete Part 5) _] General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information D Ballot Measure Committee 0 Primarily Formed 0 Controlled 0 Sponsored {Also Complete Part 6) D Primarily Formed Candidate/ Officeholder Committee {Also Complete Part 7) l.D. NUMBER COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) J)ev\1se, \\~U\-ed-'Ra..v)15h ~' 1-l<trr ~ q So2.. -s1qq ARE CODE/PHONE STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX I E-MAIL ADDRESS 4. Verification Date of election if applicab e: (Month, Day, Year) City Cl 2. Type of Statement: D Preelection Statement D Semi-annual Statement D Termination Statement D Amendment (Explain below) Treasurer(s) NAME OF TREASURER MAILING ADDRESS CITY STATE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE OPTIONAL: FAX I f:i-MAIL ADDRESS D D D COVER PAGE CALIFORNIA 460 2001/02 FORM Page of ___ _ For Official Use Only Quarterly Statement Special Odd-Year Report Supplemental Preelection Statement -Attach Form 495 ZIP CODE AREA CODE/PHONE ZIP CODE AREA CODE/PHONE I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on--------------Date /-31-0!J Executed on ----"--""'=D,...at-e--~~--- Executed on--------------Date Executed on ------,,D,-at_e ______ _ BY-------=--.,.,,--.,,,.....,,.,,,...---,,.-,,..,.-_,..----=--------~ Signature of Controlling Officeholder, Candidate. State Measure Proponent BY-------:::,-.,.--.,,,,_,....,,,......,,,.,,,..-=-~-=-....,,..,..---=-,..,---...,,---------­s;gnature of Controlling Officeholder. Candidate, State Measure Proponent FPPC Form 460 (June/01) FPPC Toll-Free Helpline: 866/ASK-FPPC C:t.,tn nf r"!'lllfn,.,,i,.