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;t~tement of Organization ~TATEMENT OF ORGANIZATION <br />tecipient CommitteeFile original end one copy with: Date Stamp <br />Secretary of State I <br />~fP.o.P°[itical Relorm DivisiOnBOx 1467 '?i i i.~ ':I? g ~' ~ '" <br />an Amendment Sacramento, CA 95812-1467 ~< <br /> and enter I.D. nu~nber: County and City Committees tile e copy with: ~ JUL 6 199<) <br /> ?~%'-'0 4~:~' Local Iil[ng officer who w~tl receive Ihe original [ i <br /> # <br /> disclosure statements. <br />STRUCTIONSONREVERSE Type or print in ink CI~ Y C)P ~EDWOOD CITY <br /> C;TY CLERK <br /> <br />· Committee Information 2. Treasurer and Other Principal Officers <br />~ OF TREASURER <br />NAME OF CO~aMITTEE <br />[ <br />C~TY SLATE Z~CODE AREACODEIP~ONEM. JMBER <br />NAM[:: AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPUCABLE <br /> <br />· Verification <br /> i have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. I certify <br /> under penalty of perjury under the laws of the State of Califomia that the fore'lng is true and correct. <br /> <br /> ~ D~TE ~j'/ --~w~' ' ~,,~' ~. ~ . SIGNATUREO~TREASURER <br /> <br />)R IN FORMATION REQUIRED TO 6E PROVIOED TOYOU PURSUANT TOTHE INFORMATION PRACTICES ACT OF 1977. SEE ~N FC~RMATION MANUAL ON P. AM~AIGN r~I.OZ~.LO.O. HRE PROVI~ION'.~ ~¢'THE POLr'flCAL REFORM Ac~'r <br /> FPPC Form 410 <br /> <br /> <br />