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STATEMENT OF ORGANIZATION <br />Statement of Organization WHERE TO FILE: [' DateStamp <br />Re~.ipient CO'm misted ,, File orlglnaland one copy of this form with'. / <br /> <br /> Political Re for m Division Jlk~lJ <br />(GovernmentCodeSections84101-84103) 'Amendment 'l~;:m°:1nt4o6,L958121467 ~-~ ~'~ ~ U ~/ L~ <br /> <br /> k J [] Check box f an Amendment The city or .county officer, if any. who receivesll~d.~j L--/I~~ ! - I <br />Typeor prJntJnJn. ~ i andenteE,.O, numb,,: committee soriginalcampaigndisclosur.And'lfapP"'cable'fit' °ne(°pY°f thlsf°'mq( ll/--I M' Y :'i ma _IUIIIIIIll I <br />SEE INSTRUCTIONS ON REVERSE J ~ statements. OF FF.~WOOO GITYonveU~K Iiii · 0F RF. DW000 ely <br /> <br /> and Other Principe <br />I Committeelnformation II Treasurer -- ~lOfficers '~-' . <br /> <br /> NAME OF TREASURER " <br /> Date qualified as [] Check box If not yet qualified <br /> Committee O~o,,h.O,y.T,,,) JEFF IRA <br /> <br /> NAME OF COMMITTEE MAILING ADDRESS <br /> <br /> §47 VETFRANS RI VD. <br /> FRIENDS OF COLLEEN JORDAN t CiTY STATE ZIPCODE AREACODE/DAYTIMEPNONE <br /> <br /> ADDRESSOFCOMMITTEE (NOTP.O. BOX)NO. ANDSTREETI REDWOOD CITY CA 94063 (650) 365-2323 <br /> 84 EDDYSTONE COURT NAMEANDPOSITIONOFOTHERPRINaPALOFFICER(S) <br /> <br /> CITY STATE ZIP CODE AREA CODEI PHONE NUMBER <br /> <br /> REDWOOD CITY CA 94065 (650) &3~-1651 MAILING ADDRESS <br /> <br /> COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IE DIFFERENT <br /> I THAN COUNTY OF DOMICILE CiTY STATE ZIP CODE AREA CODE/DAYTIME PHONE <br /> <br /> S~N MATE0 ' <br /> MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX <br /> <br /> Attach additional Information on appropriately labeled continua Sion shed ts. <br /> CITY STATE ZIPCODE j AREACODE~PHONENUMBER <br /> <br /> III Disposition of Surplus Funds You must specify what disposition will be made of leftover campaign funds, if any, qt termination. <br /> <br /> As Applicable by State Law <br /> IV Verification ' <br /> have used all reasonable diligence in prepar ng this statement a.nd to the. best. of.my kn.owledge the i.nforma?on contained herein is true and complete· I <br /> certify under penaltypf pgrjury under the laws of the ~tate of Cphfornia.that the.~oregomg is true and correct. <br /> <br /> bATS' / ' ' CITY AND STATE / ?/ ° <br /> Executed on At By _ <br /> <br /> Executed on At By <br /> State of California Fair Political Practices Commission <br /> <br /> <br />