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DISCLOSURE OF CAMPAIGN CON IBUTIOS <br />owner for a <br />(n <br />I'c , applicant for a <br />(na <br />(Asp- Pec rt Lo., uPLIB -'�L, <br />(type and number of perm—it) <br />(Please checli appropriate - - •.. • •. <br />ApplicantOwner <br />I have not .i • -any campaign <br />Planningns in the amount of $250 or more <br />to any member of the <br />Commission - • <br />ast 12 months.I have made a campaign contribution for (local) (State) (federal) election of <br />to within the last 12 <br />months. of <br />Commissioner) •- <br />I understand that Government Code Section 84308 requires this disclosup'l, <br />• I make this disclosure compliance therewith. Further, I hereby decla <br />that I shall not - any campaign• • • <br />ns of $250 or more to a <br />member of the Planning Commission while my application is pending <br />within 3 months after - a. decision -thereon by the Planning Commission. I <br />am informed and believe • :r • so <br />would be a violation of State law. <br />I declare under penalty of perjury that the foregoing is. true and correct. <br />Executed in Stockton, California; this 29 day of <br />199q <br />Owner <br />Appl'cant <br />