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Statement of Organization ' � � � <br /> � � <br /> Recipient Committee � <br /> INSTRUCTIONS ON REVERSE Pege 2 <br /> I.D.NUMBER <br /> COMMITTEE NAMf <br /> Committee to elect Janet Borgens 1374422 <br /> • All wmmlttees must list the financial institution where the campaign bank acoount is located. <br /> NAME OF FtNANCIAI INSTITUTION AAEA CODE/PHONE BANK ACCOUNT NUMBER <br /> United Ame�ican Bank (650)298-7010 0410005216 <br /> CITY STATE ZIP CODE <br /> ADDAESS <br /> 2400 Broadway St#100 Redwood City ca 94063 <br /> 4.fi+�(�tYt��'A�it#i3� C�+mptete d►e applicabte sections. <br /> � . <br /> • List the name of each controlling officeholder,candidate,or state measure proponent. If candidate or officeholder controlled,aiso list the elective office sought or held,and <br /> district number,if any,and the year of the election. <br /> • List the political party with which each officeholder or candidate is affiliated ar check"nonpartisan." <br /> • If this committee acts jointly with another controlled committee,list the name and identification number of the other controlled committee. <br /> ELECTIVE OfFICE SOUGHT OR HELD <br /> NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY <br /> � Nonpartisan <br /> Janet Borgens Redwood City Council 2015 <br /> ❑ Nonpartisa� <br /> ! . . . .�� Primarily formed to support or oppose specific candidates or measures in a single election. List below: <br /> CANDIDATE(5)OFfICE SOUGHT OR NELD OR MEASURE(S)JURISDICTION <br /> CANDIDATE(S)NAME OR MEASURE(5)FULL TITLE IINCLUDE 8ALL0T NO.OH LETTER} (tNCLUOE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONe <br /> SUPPORT OPPOSE <br /> ❑ ❑ <br /> SI�PPORT 0� <br /> J <br /> FPPC Form 410(Dec/2012) <br /> FPPC Advice:advice�lfppc.ca.gov(866/275-3772) <br /> www.fppc.ca.gov <br />