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COVER PAGE -- LONG FORM <br />Recipient Committee Type or Print in Ink. Statement oovaJl period Dale Stamp <br />Campaign Statement -- Long Form <br /> <br />~EE lt%~TRI~TIONS O~i RE~R~ through 12 - ~ 1 - 9 <br /> Checko~ofthelollowl~xemloi~catet~typeof,tatement beingliled: Date og Election J~ 2 ~ ~ ., :A ~OI6c~lDaeOrdy <br />~ P~e-et~tiofl Statement ~ Semi annual Slalemenl il applicable: <br />~ Special Odd-year Campaign Repoa IMont~ Day, Year) CI~ 0~ REDW00D QIY <br />~ Suppl~ental Pre-elation Slat~nHAaach a completed Fo[m 495 Io this slale~nL) ' N/~ CI~ CLEE~ <br />~ Terminaion Slale~nl (A~ach a c~pleled Form 415 to this stalemenL ) <br /> <br />I Committee information II Primarily Formed Committee (See definition on reverse.) <br />, List names el officeholder(s) or candidate(s) for which this <br />.,~.-~co~,~[T[[ committee is primarily formed <br />Involvement Makes Po]itical Action Count <br /> 830435 <br />Redwood City, CA 94063 (~ <br />Lawrence K, Buckmaster <br /> <br />Redwood City, CA 94063 ( <br />(Check Boxes) See definitions and important information on reverse. <br />Is this a sponsored committte? .................................... [] Yes [] No <br />Is this a broad based political committee.'? ................... [] Yes [] No <br />:: Attach additional information on appropriately labeled continuation sheets. <br />IH Verification <br />I hays used all reasonable diligence in preparing this slatemcnt and lo the besl of m); knowledge the information~containcd herein and in thc attached schedules is true and <br />complcm. I c~rtify~undar penalty of perjury under the laws of the Slatc of California that thc foregoing is Irue a~l correct. / <br />Slate el Calllornla Fair Political Practloae Commla.lon. <br /> <br /> <br />