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Recipient Cornmittee Type or print in ink. ��S��P " � c°ve��,cE <br /> Carnpaign Statement . . . <br /> .�over Page �� � � � � <br /> (Government Code Sections 84200-84216.5) �E P � �, ?015 , . <br /> Statement covers period Date of electlon If applicable: _ <br /> from July 1, 2015 tMonth, Day, Year) ` �'age ': � ot 8 <br /> . <br /> Far�OH(cfal Uae Only <br /> SEE INSTRUCTIONSON REVERSE thl'ough September 19, 20�5 2015 Election <br /> 1. Type of Recipient Committee: All Committeea-Complete Parts 1,s,3,and 4. 2. Type of Statement: <br /> � Officeholder,Cendidate Controlted Committee ❑ Ballot Meesure Committee ❑ Preelaction Statement ❑ Quartery Statement <br /> Q State Candidate Election Committee Q Primarily Formed ❑ Semi-annual Statement <br /> Q Recall Q Controlled ❑ Special Odd-Yesr Report <br /> (AlsoCompbte Pert SJ ❑ Termination Statement <br /> Q Sponsored Amendment ❑ Supplernental Preelection <br /> (AlsoCompletePaRBJ � (Explain below) Statement-Atlach Form 495 <br /> ❑ General Purpose Committee <br /> Q Sponsored ❑ Primarily Formed Candidate/ Addresses and Empl�yment were missing on orlqinal submis ion of <br /> Q Small Contributor Committee Officeholder Committee pre election statement. <br /> Q PolittcalParty/CentralCommittee (A��oCompletePart7) <br /> 3. Comrnittee Informatlon �1374422 Treasurer(s) <br /> COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER <br /> Comrnittee to Elect Janet Borgens for Redwood City Council 2015 Hollis Matheny <br /> MAILING ADDRESS <br /> <br /> STREET ADDRESS(NO P.O. BOX) CITY STATE ZIP CDDE AREA CODEIPHONE <br /> Union City Ca 94587 ( <br /> CITY STATE 21P CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY <br /> Redwood City Ca 94063 ( <br /> MAIIINQ AODRESS(IF DIFFERENT) NO.AND STREET OR P.O. BOX MAILING ADDRESS <br /> CITY STATE 21P CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE <br /> OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/E•MAIL ADDRESS <br /> 4. Veriflcatlon <br /> I have used all reasanable diligence in preparing and reviewing this statement and to the b st of my knowledge the infor tion contained herein and in the attached schedutes is true and complete. I <br /> certify under penafty of perjury u der the laws of the State of California that the foreg ' is true and co t, <br /> Executed on � � �� <br /> �, By <br /> Z /� S r }Tr r sistentTreasurer <br /> Executed on By <br /> �� gnetureofConfrolllnpOtficehokler,Cendl e,SteteM eProponentorResponsiWeOHicerofSponeor <br /> Executed on By <br /> �� Signature olControllinp OKiceholder,Candidate,Stete Meesue Proponent <br /> Exacuted on By <br /> ��e SignatureofControllingOfficeholder,Candidate,5tateMeasuraProponenl FPPC Form460(June/01j <br /> FPPC Toll-Free Helpline:866/ASK-FPPC <br /> State of CailforNa <br />