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STATEMENI' OF ORGANIZATION Statement of Organization T~. or Print i. Ink. Amendment Dale SIamp Recinient Committee ~_~ ch~k ~. ~, (Govc~cnt'' 'r- -C~c S~don~ 84101-84103) and cmc~ ! .D. A Fo~ OllicialUse Only 851670 SEE INSTR~T~NS ON REVERSE File original and one copy of this form ~vith: And, if applicable, file one copy or Dale qualified a~ Secretly of State this form witil: Committee: (M~fl~, Day, Y~) Political Reform Division ~e city or county officer, if ~y, who r P.O. Box 1467 receives the coumfill~'s original 1988 Sacramento, CA 95812-1467 c~paign disclosure statements. ~ C~leck ~ d nol yet qualifi~ I Committee Inlormation II Treasurer and Other ~incipal Officers ~E ~ ~MI~EE: NAME OF T~R: Geocgi ~a Beige Citizens to Re-elect Georgi La Berge ~.INaA~ESS: (IFDIFFEREN[~H~COMMIIlEUS) A~ OF C~MI~EE: (~[ PO. ~x) NO AND ST~ET [ C~N~: CIIY STALE ZiP CODE A~EA C~)[:II)AYI IME PIIONE 1637 Carleton Court [ San Mateo Cl~ STALE ZiP C~E NAME AND ~SI[I~ ~ O[I IER ~tlNCIPAL OFFICER(S): Redwood City CA 94061 ~E~G A~)~: (IF DIFFE~NT) NO A~ ST~ET ~ P 0 ~X ~lt lNG A~RE~: (IF DIFFERENT Ttt~ COMMIIIEE*S) (415) 574-6231 Cl~ STALE ZiP C~E A~ C~ ~E NUMBER Cl~ STALE ZiP C~E AR~ CODE/DA~ IME PI lONE Attach additional infornLation on appropriately labeled continuation sheets. III Controlled Committee Is this committee cona'olled by an officeholder, candidate, or slate measure proponent? (See definition and important it[formation on reverse.) ~ Yes (Complete the following) El No · If this committee is controlled by an officeholder or a candidate, list the name of the controlling officeholder or candidate, the elective office sought or held, add district number, if any. If this committee is controlled by more than one candidate, list the mune of each controlling candidate. · If this committee is conltolled by a slale measure proponent, list the name of the slate measure proponent. If this committee is conuolled by more than one state measure proponenl, list the name of each slate measure proponent. · If this committee acts jointly with another controlled committee, list the name and idenlificalion number of the other controlled commiltee. Georgi La Berge, Treasurer Attach additional infor.u~tion on appropriately labeled continuation sheets. You must complete the Verilicalion on Page 2. FOIl INFOHMAHON rIE(~UIRED IO BE PROVIDED TO YOU PURStJANE lO TI IE IHFORMA11(_)H ['RACIlCES ACE OF 1911. SEE IN/~OfiM~II_C)~J M2~ilJAL ~2] CAMPAIGN DtSGLOSUJIE I~J]OVL, SION~ ~Elt ]E ~2QLIIlGAL []E[OILM ~ I Slate of California Fair Polillcal Practices Commissio.