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- COVER PAGE <br /> Recipient Committee a � . , � � ' <br /> Campaign Statement ����/�� � . . <br /> Cover Page <br /> Statement covers period Date of electio if applicabl Page 1 of � <br /> from <br /> 10/18/15 (Month,� y,Year) � B a� 2016 For Official Use Only <br /> �if�r t�f€��W�,t�Ciry <br /> SEE INSTRUCTIONS ON REVERSE through 12/31/15 1 1/ 15 �i ��� <br /> � <br /> 1. Type of Recipient Committee: All Committees-Complete Parts 1,z,s,and 4. 2. Type of Statement: <br /> � Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement <br /> � State Candidate Election Committee Committee � Semi-annual Statement ❑ Special Odd-Year Report <br /> � Recall � Controlled ❑ Termination Statement <br /> (AkoCanpletePaR5) � Sponsored (AlsofileaForm410Termination) <br /> (Also Complete Part 6J <br /> ❑ General Purpose Committee ❑ Amendment(Explain below) <br /> � Sponsored ❑ Primarily Formed Candidate/ <br /> � Small Contributor Committee Officeholder Committee <br /> � PoliticalParty/CentralCommittee (AlsoCwnpleteVeR7) <br /> 3. Committee Information �•D.NUMBER Treasurer(s) <br /> 1376624 <br /> COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER <br /> Shelly Masur for Redwood City Council 2015 Shelly Masur <br /> MAILING ADDRESS <br /> 440 Birch Street <br /> STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE <br /> 440 Birch Street Redwood City CA 94062 650-814-0349 <br /> CITY STATE ZIP CODE AREA CODEIPHONE NAME OF ASSISTANT TREASURER,IF ANY <br /> Redwood Ciry CA 94062 650-814-0349 <br /> MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX MAILING ADDRESS <br /> CITY STATE ZIPCODE AREACODE/PHONE CITY STATE ZIPCODE AREACODE/PHONE <br /> OPTIONAL: FAX/E-MA�LADDRESS OPTIONAL: FAX/E-MAILADDRESS <br /> 4. Verification <br /> I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. I <br /> certify under penalty of pery'ury under the laws of the State of California that the foregoing is true andmrrect. <br /> Executed on '� -'�-� ` �0 gy C� \.' VVW� Jt�v� <br /> �gn'tu ofTreasurerorASSisNantTreasurer <br /> Executed on '���,�� � gy � � '" <br /> Date Signature of Controlling i older,Candidate,State Measure Proponent or Responsible Officer of Sponsor <br /> \ <br /> EXeCUted On Date By Signature�of� nholling Officeholder,Candidate,State Measure Proponent <br /> Executed on Date By Signature of Controlling Officeholder,Candidale,State Measure Proponent <br /> FPPC Form 460(Jan/2016) <br /> FPPC Advice:advice@fppc.ca.gov(866/2753772) <br /> www.fppc.ca.gov <br />