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Statement of Organization <br />Recipient Committee <br />Statement Type ® initial <br />19 Not yet qualified <br />or <br />Q Date qualified as committee <br />❑ Amendment <br />Date qualified as committee <br />1 'Gommtttet*tnfigrmatiut I.D. Number <br />(if applicable) N/a <br />NAME OF COMMITTEE <br />Jason Galisatus for Redwood City Council 2018 <br />STREET ADDRESS (NO P O BOX) <br />2007 Woodside Road #2 <br />CITY STATE ZIP CO DE <br />Redwood City CA 94061 <br />MAILING ADDRESS IIF DIFFERENT) <br />PO Box 610065, Redwood City, CA 94061 <br />E MAIL ADDRESS(REQUIRED)/FAX(OPTIONAL) <br />jason@jason4rwc.com <br />❑ Termination — See Part 5 <br />AREA CODE/PHONE <br />650 521 1772 <br />COUNTY Of DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE <br />San Mateo ity of Redwood City <br />Attach additional information on appropriately labeled continuation sheets. <br />Date of termination <br />REOME® <br />AUG ) 0 2018 <br />City of Redwood City <br />City Clerk <br />-FORM For Official Use only <br />Cindy Galisatus <br />STREET ADDRESS (NO P O BOX) <br />518 Hillside Road <br />CITY STATE ZIP CODE AREACOOE/PHONE <br />Redwood City CA 94062 650 743 5210 <br />NAME OF ASSISTANT TREASURER, IF ANY <br />STREET ADDRESSING PO BOX) <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />NAME OF PRINCIPAL OFFICER(S) <br />STREET ADDRESS (NO RO SOXI <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />—. - — ..-m—.— uiu6o l=c III PI CPDD 11 IS LIUb ,Ld LCnronL dna to Lne Dest or my Knowledge the Information contained <br />penalty of perjury under the laws of the State of Ca'forniilall ha o .going is true and correct. <br />Executed on 08/03/2018 By <br />DATE SIGNATURE FTREASURER 0R ASSISTANT TREASURER <br />Executed on 08/03/2018 _ <br />DATE By i <br />SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT <br />Executed on By <br />neTF <br />SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT <br />Executed on By <br />DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT <br />FPPC Form 410(February/2018) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />