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J a n 1 5 0 7 0 9 1 5 p Tom A n t h o n y 5 6 3 - 8 7 5 - 7 2 5 7 p . 2Fop 1NSTAUC noNS, SE6 BACKOF FOAMDI SCLOSURE SUMMARY PAGECOMMI TTEE NAME ( Mu s t b e s ame a s o n St a t e me n t o f Or g a ni z a d o n)i , CNr f EU5- f -A- F ! - t ~ i QA) o s ~ 4 d , - 1 ~t ~~L V - 4 1 0 , ~c r n

I I MPORTANT : I n d i c a t e t y p e o f c ommi t t e e y o u a r e r e p o r t i n g t a r .( 1 ) S t a t e w i d e f L a g i s l a t i v e C a n d i d a t e ( 2 ) S t a t e w i d e PAC ( 3 ) S t a t e P a r t y ( 4 ) C o u n t y f L o c a i C a n d i d a t e( 5 ) C o u n t y PAC ( & ) B a l l o t I s s u e f F r a n c h L s e Commi t t e e ( 7 ) C o u n t y # ' C l t y C e n t r a l Commi t t e e( S ) S u p p o r t S l a t e o f C a n d i d a t e s _

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Ro u t i n e Pena l t i e s Due Fo r L at e Fl ed Re p o r t s Range f r o m $ 2 0 t o $ a 0 0SEE I NSTRUCT I ONS ON BACKAND COMPLETE T 1 4 E FOLLOWI NG SENTENCE :I AM F I L I NG A D6C6/ 2 7 &' - P- 9 ( 4 _0~>C~ REPORT FOR ANNA ( 1 ) ELECTI ON I ( 2 ) NON- E L ECT I ON YEAR.

( r e p o r t d a t e ) I n d i c a t e on emECHECK I F AMENDMENTTOREPORT DATED

Ch e c k i f t h i s i s f i n a l ( t e r m i n a t i o n ) r e p o r t a n d at t a c h No t i c e o f Di s s o l u t i o n Foam UP - 3 .( Yo u mu s t c o nt i nu e t o f i l e r e p o r t s u n t i l a No t i c e o f Di SSCI U1 f D R i s f i l e d . )

STATEMENT OF CASHON HANDCASH ON HAND a t t he beg i nn i ng o f t h e r e po r t i n g p er i o d . ( T h i s i s t he t o t a l o f a l l mo n i e s he l db y t h e c o mmi t t e e . Th i s amount MUST b e t h e s ame as t h e c a s h o n h an d a t t he e n do f t he l a s t r e p o r t i n g p e r i o d , o r mu s t b e z e r o i f t h i s i s f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

ADDTOTAL MONEY TAKEN I N THI S PERI ODSc h e d u l e A : Cash Co nt r i bu t i o ns t o t a r ( At t ac h Sc h e d u l e A) ( ' a l s o s ee i n - k i n d b el o w) . . . . . . . . .Sc h e d u l e F : L o a n s Re c e i v e d t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e d u l e H - . T ot a l Sa l e s o f Camp a i g n Pr o per t y ( A t t a c h Sc h e d ul e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Sc h ed u l e " r o l e s t o Ca nd i d a t e s ' Commi t t ees On l v )

" UNPAI D BI L L S ( F r o m Sc h ed u l e D - At t a c h Sc h e d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . $* I N KI ND CONTRI BUTI ONS ( F r o m Sc h e d u l e E - At t a c h Sc h e d ul e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

. __ - OUTSTANDI NG LOANS ( F r o m Sc h e d u l e F - At t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CANDI DATE COMMI TTEES ONLY :CONSULTANT BREAKDOWN ( Sc h ed u l e GAt t a c h ed ? )VALUE OF CAMPAI GN PROPERTY ( F r o m Sc h e d u l e H - At t a c h Sc h e d ul e H) $

FORMDI SCLOSURE

( Re v . 0 1 / 2 0 0 1 ) REPORTFo r O f f i c e Us e On l yConI n dA u d i t e d _Compu t e r

L o c a l Commi t t e e s , e n t e r Da t e o f E l e c t i o n

C o u n t y & L o r a l C o mmi t t e e s , e n t e r Co u n t y i nw h i c h E l e c t i o n i s h e l d

SUB- TOTAL . . . . . 3 ( . 0 2 1 ~ 14SUBTRACT TOTAL MONEY SPENT THI S PERI ODSc h e d ul e B: Ex p en di t u r e s t o t a l ( A t t ac h Sc h e d ul e B ) ( " a l s o s e e d eb t s a n d l o an s b el o w) . . . D l l `Sc h e d u l e F : L o a n Re p a y me n t s t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CASHON HAND a t t he e n d o f t h i s r e p o r t i n g p er i od ( i f f i n a l r e p o r t , b al a nc e must Zb e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . _ . . . . . . . . . . . . . . . . . . $ ZoG

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Fo r I n st MCi l o r n s , See Back o f Fo r m _-A MONETARY( R e v . 0 5 ( 8 7 ' ) RECE I PTSCONTRI BUTI ONS-MONEYTAKENT N( I n r j u d t l a p o nd da t e ' a p a l t s a r s s l "ams)

CQMA6TTSENAME( Mus t b e s ame SS On S h r f a r n e + t t o f On ge r * & V Dn )Z ! / W ! fEL S 4 - 4 - 4 ~ ~ l ~ l oNvG" = A +~1 4 ' c , A 1 - AGf t ~ l r ~ - ~ 1 ~

S T A T I r GANDI DAM NOTE : I F A C OP t T R I B U T I O N I S R E C E I V E D FROmA S T A T E PAC. ( P O L MC A L AC" ONC O I I u u T T I E O . L L S T T H E PAC I O E NT I F I U T 7 ONNUMWAAND THE PAC ChECB NUMOER I N T HE D E S I G NA T E D COWUN, A UST OF I D N u h 1 0 E R S I S A V A t t A R L E FROMTHE I O WA E T h l = AND C J 1 L C P A "D I S C L O S U R E DORM .CAUT I ON : S e c V o n 8 f 9 B . 3 2 A ( a ) , l a v a Cads . p r o b at t h e umo f l n i o ml s d o n c o p i e d t r o t r o p g m s a n d s t a t a mam f o r s o f i c * r t g wn t r i b u~ a o rf o r a n y c o r m n e l d a t p u r p o s e b y a v y P e r s o n o t h e r v a n s t g p A Dq p a b c s l c o mn * Me a s .

TOTAL I V h d PRYO o f t h i s s c * S d l d e ) -' OI Wowt a WWMOO" c s w l d a c s CWWOwa I D a a a o a a t h s r e f p a e oWu f a n y n t a b v a mak Y* ! C a A f b s d f m bMu v n w i t w & W4 +b - W* mmi b e Www t o t t a a a l m d d a p a a dmnaanp uy O l o n d n ( I n N I a s ) I l e o a1 l t ( e w Q u a t Mmw" 2P) ( S" P a g e 2 o f l o an s p sdw) L n a t t T a n+ ddC r o + r t t t b W d r a Us ai mswe i n d ) d s l s , f a r t Owe i s n ot am" r e l s u o n smp , -*o r no r a1+po esme' i 1 Me r e ao l r h i p a o l u mf L

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l i f t aoxA~. EaToc w1s c a r r t r l ~s aaY:P r s mh e s e s Of Owt a i n c a r n p a a i g o pn3pLY~DfMa t r r a mmudaho b e i n r e n h a r l e d o n Sd r o d u l e H. ( Re f sbSd t edWeHi n s i n a c f o r f c . )

bP P~ i O c a ma r f i s r d . a r d v ~. v i a g , f v r d i a i r ~ ap . P a B . i r r ~ a B~ B " 9s s~ i a e s t u r r e t a l s o b e d r awl f b a r a t a r a d o nSc h e d ul e Gb y I EamaAMpvpawa n d d ol e o f s s d r t y p e a t mWe r a d t a a r a r r r d e b y t h e persm*f a n t a d a YF o f t h e a s a d l d v Ws e a a r r n l t t a e . p o l a r t oSd wd r i eGi r s b uc f o r u a n d I o wa ( l od e 6 RA A W3 ) ( f ) . )o f

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STATE1PACOOMKVEESNOMFOROONTRwroMSMADE To STATE%OE OR L I GI SLAT f W DCHECKTHI S BOXI FCANDI DATTS . LI STTFECANDWTEMEMTFI CATI ON MU MBt I N TWc DES1GHATTDCCI i I I t MA ND THEp AC Ct S 1C I A I I M E l t FqRFACH E l t i ' f a 4 O M I F t E A L J 6 r OF I D NUi BEFS I S AVARABLF = Mi l l THE f ONYA AMENDI NG FORMSTHI CS r i CAMPAI GN 0 0 t f J _ O GUR6 9Qr 1RO' .COvur TTMHWE( Mu s t be SWWwo n Sbe vn e n t o f Ol 9wVWI dn n)U , 1 r f 6- t ) 5"9l i n , Y a , bF = v a - ) A 7 > , 7 ~ ~ . e f - / CAL. AI G4t o- ,J - F u t J0

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