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STA'rEMENi' ()F ORGANIZATION <br />Statement o! Organization Ty.e or Print in Ink. Amendment <br />Recipient Committee ~_/~ / ~ c,,~ ~ ,, ~, ~,.~,,,,,,,~., <br />(Govc.u.cm C~c S~do.s 84 IO1-84103) . ~nd cmer I.D. number: <br />SEE INSIR~I ~.S ON nEVERSE ~ ~ 851670 RECEIVED <br /> AND FILED <br />File original and one copy of Ihis form wilh: A,d, i[ applkable, ~le one copy of Dale qualified a~ ~ ~oi°ff~ce~e 5t~e°~ ~eot~relo~li~ol StYe <br />Scc[cl~y o[ Slalc lhls form wilh: Commillee: (M~.D~y. Y~) <br /> <br /> Polilicai Rcfom, Division ~%c ir AUG 3 0 <br /> P.O. Box 1467 receives a~e commiu~'s original 1988 <br /> Sacramcnlo, CA 95812-146~ canpai~n disclosure slalcmcms. {3 <br /> <br />I Commiltee Inlormalion II ~reasurerandOIher~incipalOfficers <br /> ~ME ~ C~MI~EE: NAME O~ <br /> <br /> Citizens to Re-elect Georgi La Berge ~ILINGADDRESS (IEOIFFEHENIlII~COMMIIIEE'S) <br /> <br /> AOORESS OE COMMI D'EE: (NOI P O. BOX) NO AND STREET COUNIY: ClIY STA1 E ZIP CODE AFIEA CO{)EIOAYI IME Pi lONE <br /> <br /> 1637 Carleton Court San Mateo <br /> ClIY S[AIE ZiP COOE NAME AND I'~OSlllON OF OILIER R~INCIPAL OI:FICER(S) <br /> <br /> Redwood City CA 94061 <br /> MAlt. lNG ADOR£SS: (IF DIFFERENT) NO. ANO STRI:ET OR P O BOX MAIl lNG ADORESS: (IF DIFFEREN[ IItAN COMMII lEE'S) <br /> <br /> (415) 574-6231 <br /> CI]~' STATE ZiP CODE AREA COOFJR lONE NUMBER CIIY SIAIE ZIP CODE AREA CODFJDAY1 IME PI lONE <br /> <br /> Attach additional information on appropriately labeled continuation sheets. <br /> <br /> III Controlled Committee <br /> Is this committee controlled by an officeholder, candidate, or state measure proponent? (See definition and intportant inforn~tion on reverse.) <br /> ~ Yes (Complele the following) [] No <br /> <br /> · If lhis committee is controlled by an officeholder Or a candidate, list the name of file controlling officeholder or candidate, the elective office sought or held, and district <br /> number, if any. If this committee is controlled by mote Ihan one candidate, list the name of each controlling candidale. <br /> · If this committee is controlled by a state measure proponent, list the name of the slate measure proponent. If this commillec is controlled by mote than one stale measure <br /> propouem, list the name of each state measure pToponent. <br /> · If this committee acts jointly with another controlled commiltee, list the name and identification number of Ihe other controlled committee. <br /> <br /> Georgi La Berge, Treasurer <br /> <br /> Attach additional information on appropriately labeled continuation sheets. <br /> You must complete the Verilicalion on Page 2. <br /> <br /> FOH INFOIIMAIION FIE()LJIFIED 10 BE PROVIDED 10 YOU PURSUAH[ 10 Jill IrlFOI]MAII()tl PfiACIICES ACI OF 1971. SEE INfOZqMAILQH MAblUAL Obi CAMI~AIGH DIEgLC)EUJ'IE ['[IOVI~IC~I,JS Ql: tile P_QLIIIL~AL [IL.I QIB~I AG! <br /> <br /> Slate gl Calilornia Fair Pollllcal Praclicos Commissiolt <br /> <br /> <br />