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Recipient Committee Statement <br />Campaign <br /> <br />(Govemment Code Sections 84200 - 84216.5) <br /> i~:..C FY OF REDWOOD CITY <br /> State~mnt covers pe~o4 Date of Election if app#ca ClTY~__.__._CLERI~ A For Official Use Only <br /> <br /> fTom 01/01/2004 (~o~h, Day, Yea~ <br /> thmugh 01/17/2004 <br /> <br />1. Type of Recipient Committee: 2. Type of Statement: <br /> [] Officeholder, Candidate Controlled Committee [] Ballot Measure Committee [] Pre-election Statement [] Quarterly Statement <br /> O State Candidate Election Committee O Primarily Formed [] Semi-annual Statement [] Special Odd-Year Report <br /> O Recall O Controlled [] Termination Statement [] Supplemental Pre-election <br /> O Sponsored [] Amendment (Explain below) Statement - Attach Form 495 <br /> [] General Purpose Committee <br /> O Sponsored [] Primarily Formed Candidate <br /> O Small Contributor Committee Officeholder Committee <br /> O Political Party/Central Committee <br /> <br />3. Committee Information '9°~"0u;;E; Treasurer(s) <br /> COMMITFEE NAME NAME OF TREASURER <br /> Citizens to Re-elect Ruskin Ash Pirayou <br /> <br /> <br /> <br /> C~TY STATE ZIPCOOE AREACODE/PHONE <br /> San Jose CA 95113 ( <br /> CiTY STATE ZiP CODE AREA CODE/PHONE <br /> Redwood City CA 94061 ( NAMEOFASSISTANTTREASURER. IFANY <br /> <br /> STREET ADDRESS (IF DIFFERENT) NO AND STREET OR P.O. SOX <br /> STREET ADDRESS <br /> <br /> CiTY STATE ZIP CODE AR~ CODE/PHONE <br /> CITY STATE ZIP CODE AREA CODE~PHONE <br /> OPTIONAL: FAYJE-MAIL ADDRESS ( <br /> ( / OPTIONAL: FAX;E-MAIL ADDRESS <br /> <br />4. Verification <br />I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the informatio<contained'~erein and in the attached schedules <br />is true and complete. I certi~ under penalty of pedury under the laws of the State of California that the foregoing is tru, e, an,d'~ect. · <br /> Executed on ([~1~) ~'~F By ~/~ //~ / <br /> Executed on /,/.~-~ / ~) ~" By ~ ~'( .~'~'-~'~ I~ R OF SPONSOR <br /> ~ ~ DATE SIGNATURE OF CONTROLLING OFFIC EHO~'~E~, CANDIDATE, STATE MEASURE PROPONENT OR RESPO~;;~BLE OFFICE <br /> <br /> Executed on By <br /> DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT <br /> <br /> Executed on By <br /> DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT <br /> <br />S/CCW - PCAB05 01380 (Rev. 9/99) State of California Fair Political Practices Commission. <br /> <br /> <br />