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COVER PAGE - LONG FORM Officeholder, Candidate s,.t~,.., cove~ i~.,-',~ Date Stamp and Controlled Committee 01/01 Campaign Statement - Long Form [~ l~ ~ ~] i 6 (Government Code Sections 84200 - 84216.5) through 0 Page of [] Pre-election Statement Date of Election 9. For Official Use Only [] Supplemental Pre-election Statement (Attach a completed Form 495 to this statement.) if applicable: JUL 3 I 1996 [] Special Odd-Year Campaign Report (Month, Day, Year) [] Semi-annual Statement [] Termination Statement (Attach a completed Form 415 to this statement.) "OF REDWOOD CITY I Officeholder, Candidate, and Controlled Committee II Statement: Included in this Statement List any other committees not included in this consolidated statement that are controlled NAME OF OFnCHOLDER OR CANDIDATE: by you and any committees of which you have knowledge that are primarily formed to Matt Leipzig receive contributions or to make expenditures on behalf of your candidacy. OFFICE SOUGHT OR HELD: (INCLUDE LOCATION AND DIS'rRICT NUMBER IF APPUCABLE} COMMI'I-rEE,~ME: I I.D. NUMBER I RESIDENTIAL OR BUSINESS/t4:)DRESS: (NO. AND STREET) 5 80 E1 Camino Real NAMEOFTREASURER: CONTROLLED COMMITrEE? cn'Y STARE ZIP CODE AREA CODEJDAYT1ME PHONE [] YES [] NO San Carlos CA 94070 (415) 593-5888 COMMITTEE ADDRESS: (NO. ANDSTFIEET) COMMITTEE NAME: I I.D. NUMBER Friends of Matt Leipzig Ii 951036 c~Y STATE ZIPCODE AREACOD~JDAY~MEPHONb COMMITTEE ADDRESS: (NO. AND S3REET) COMMD'TEE NAME: I.D. NUMBER 580 E1 Camino Real cI'rY STATE ZIP C, ODE AREA CODE/DAYTIME PHONE San Carlos CA 94070 (415) 562-3565 NAMEOFTREASURER: CONTROLLEDCOMMrFI'EE? NAME OF TREASURER: [] YES [] NO Larry Aikins COMMI'I-rEE ADDRESS: (NO. AND STREET) PERMANEN'I' ADDRESS OF TREASURER: (NO. AND STREET) 926 Woodside Road CITY STATE ZIPCODE AREACODE/DAYTIMEPHONI= CFFY STATE ZIP CODE AREA CODE/DAY'rIME PHONE Redwood City CA 94061 (415) 369-7331 Ill 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 At By DATE CITY AND STATE SIGNATURE OF TREASURER I have used all reasonable diligence and to the best of my knowledge the treasurer has used all reasonable diligence in preparing this s.!a~t. I have reviewed the statement and to the best of my knowledge the information contained herein and in the attached schedules is true and comple~ certi~ under pen;~l~j; ofjgerjury under the laws of the State of California that the foregoing is true and cqll:ect. Executedon , ^t Executed on ,At By DATE CITY AND STATE SIGNATURE OF CANDIDATE/OFFICEHOLDER Executed on At By DATE CITY AND STATE SIGNATURE OF CANDIDATE/OFFICEHOLDER S/CCW - PCAP02970457 (Rev, 3/94) State of California Fair Political Practices Commission.