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El <br />Statement -of Organization <br />Recipient Committee <br />INSTRUCTIONS ON REVERSE <br />COMMITTEE NAME <br />Redwood City Teacher's Association Political Action Fund <br />• All committees must list the financial Institution where the campaign bank account is located. <br />NAME OF FINANCIAL INSTITUTION I AREACODE/PHONE <br />ADDRESS CITY <br />4...Typ@ of Committee Complete the applicable sections. - <br />BANK ACCOUNT NUMBER <br />STATE ZIP CODE <br />CALIFORNIA <br />FORM i ! <br />Pam Z <br />LD, NUMBER I <br />1347115 <br />' II <br />r <br />• List the name of each controlling officeholder, candidate, or state measure proponent. if candidate or officeholder controlled, also 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 or 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 />-- -Nonpartisan <br />Primarily Forined Committee Primarily formed to support or oppose specific candidates or measures In a single election. List below: <br />CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO, OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION <br />(INCLUDE DISTRICT NO., CITYOR COUNTY, AS APPLICABLE) CHECK ONE <br />SUPPORT OPPOSE <br />S� Oln <br />FPPC Form 410 (Dec/2012) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />