Form 465 (2)Supplemental Independent
Expenditure Report
(Government Code Section 84203.5)
SEE INSTRUCTIONS ON REVERSE
1. Committee/Filer Information
COMMITTEE/FILER'S NAME
MAILING ADDRESS
ADDRESS (NO P.O. O/~ 13 1-1 l.Av, C1'l t • _ ~4- T~W-7 CITY
STATE ZIP CODE " AREA CODE/PHTDNE
STATE ZIP CODE AREACODE/PHONE
OPTIONA ' FAX/E-MAIL ADDRESS OPTIONAL: FAX/E-MAIL ADDRESS
Ao e,- N e~,eil h lk.,ye'f
2. Name of Candidate or Measure Supported or Opposed CHECK ONE
NAMEOFCANDIDAT OFFICE SOUGHT OR HELD AND DISTRICT, IF APPLICABLE SUPPORT OPPOSE
CG v e-r C~
v Z
NAME OF BA OT MEASURE BALLOT ./LETTER JURISDICTION SUPPORT OPPOSE
3. Independent Expenditures Made Attach additional information on appropriately labeled continuation sheets.
CUMULATIVE TO DATE
DATE
NAME AND ADDRESS OF PAYEE
DESCRIPTION OF EXPENDITURE
AMOUNT
JAN. 1 DEC. 31
►~a ~v
~ X de~t~ ►XS~ vS
X33o v4,6%rIsrN
0
c
Type or print in ink.
Amounts may be rounded to
whole dollars.
❑ Amendment (Explain Below)
Report covers period
from
tnrouynSig f 3--T1~
Date of election if applicable:
( onth Day, Year)
11121/a
SUPPLEMENTAL INDEPENDENT EXPENDITURE
Date Stamp CALIFORNIA 465
FORM
2010 OCT -4 Phi Mgt- of
For Official Use Only
I.D. NUMBER (If recipient committee)
Treasurer (If recipient committee)
NAME OF TREASURER
FPPC Form 465 (January/05)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
Type or print in ink. SUPPLEMENTAL INDEPENDENT EXPENDITURE
Supplemental Independent
Amounts may be rounded Report covers period
Expenditure Report to whole dollars. ex-m-W,
Me
from
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
through I Page of
I.D. NUMBER (If recipient corn.)
4. Summary
/
1. Total independent expenditures of $100 or more made this period. Part 3. $ O U~
2. Total independent expenditures under $100 made this period. (Not itemized.) $
3. Total independent expenditures made this period (Add Lines 1 + 2.) TOTAL $ G
5. Filing Officers Enter the name and address of each filing officer with whom the filer's most recent campaign statements (Form 450, 460 or 461) have been filed.
1) NAME OF FILING OFFICER 3) NAME OF FILING OFFICER
Nt~2c~ l J ~_T S,
ADDRESS (NO. AND STREET) ADDRESS (NO. AND STREET)
CITY STATE ZIP CODE CITY STATE ZIP CODE
2) NAME OF FILING OFFICER 4) NAME OF FILING OFFICER
ADDRESS (NO. AND STREET) ADDRESS (NO. AND STREET)
CITY STATE ZIP CODE CITY STATE ZIP CODE
6. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under
penalty of perjury under the laws of the State of California that the foregoing is true and correct. __1_1
Executed on --V&r ~ 2,01 C/
ATE
Executed on
DATE
Executed on
DATE
Executed on
DATE
By
ASSISTANT TREASURER
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
FPPC Form 465 (January/05)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. STATE MEASURE PROPONENT, OR RESPONSIBLE OFFICER OF SPONSOR
By