Los Angeles County Registrar-Recorder County Clerk

Dean C. Logan
Registrar-Recorder/County Clerk

Department Headquarters
12400 Imperial Highway
Norwalk, California 90650

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Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5)	CALIFORNIA FORM 460

NAME OF FILER
Committee to Elect Dr. Delaney Smith for County Supervisor

I.D. NUMBER
000000

Election Date:
(Month/Day/Year)

I.	Type of Recipient Committee
	Officeholder, Candidate Controlled Committee
II.	Type of Statement
	Semi-Annual Statement
III.	Committee Information
	Committee Name :	Committee to Elect Dr. Delaney Smith for County Supervisor - 000000
	Committee Address :
	Mailing Address (if different) :
	FAX Number :
	E-Mail Address :
	Treasurer Name :	Delaney Smith
	Treasurer Address and Phone Number :
	Assistant Treasurer Name :
	Assistant Treasurer Address and Phone Number :
	Treasurer FAX Number :
	Treasurer E-Mail Address :	None

IV.	Verification
	I have used all reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my knowledge the information contained herein and in the attached schedules 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.

	Executed On :	By :
			Signature of Treasurer or Assistant Treasurer
	Executed On :	By :
			Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor
	Executed On :	By :
			Signature of Controlling Officeholder, Candidate, State Measure Proponent

V.	Officeholder, Candidate, and Controlled Committee
	Name of Officeholder or Candidate :	Delaney E Smith
	Office Sought or Held (Include Location and District Number if Applicable) :	Board of County Supervisors - 02
	Residential or Business Address and Phone Number :