Redwood City Teachers Association PAC 04-20-2012 Initial City 410

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Statement of Organizationl�'_7:D?% Type or print in Ink Recipient Committee Statement Type ® Initial L ❑ Amendment Not yet qualified ❑ or List I.D. number: 4 1 10 1 12 1 1 Date qualified as committee Date qualified as committee (If applicable) 1. Committee Information NAME OF COMMITTEE Redwood City Teachers Association Political Action Fund STATEMENT OF ORGANIZATION Date S R CEIVED >W►�►ID F in tt�e of iw of the Secretary ❑ Termination — See Part 5 of the state of cal a List I.D. number: STREET ADDRESS (NO P.O. BOX) 1235 McAllister St. #318 CITY STATE ZIP CODE AREA CODE/PHONE San Francisco CA 94115 (415) 307-8205 MAILING ADDRESS (IF DIFFERENT) P.O. Box 610118 Redwood City, CA 94061 OPTIONAL: FAX I E-MAIL ADDRESS COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT 5qn f:r%A In C 1.5.c o THAN COUNTY OF DOMICILE sell MeW@Sa in vrol4Po Attach additional information on appropriately labeled continuation sheets. APR 2 0 2012 JAN 3 0 2014 1 I and Didw@d, SaC�a fry OF AaDWOM CITY Date of Termination Bow+ s"t2 Ory CLRFIK 2. Treasurer and Other Principal Officers NAME OF TREASURER Sean Higgins STREET ADDRESS (NO P.O. BOX) 1235 McAllister St. #318 CITY STATE ZIP CODE AREA CODE/PHONE San Francisco CA 94115 (415) 307-8205 NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE NAME OF PRINCIPAL OFFICER(S) Bret Baird STREET ADDRESS (NO P.O. BOX) 510 Driscoll Place CITY STATE ZIP CODE AREA CODE/PHONE Palo Alto CA 94306 (650) 255-2623 3. Verification I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on 4118/12 By '1 DATE ' SIGNATURE OF TREASURER OR ASSISTANT TREASURER Executed on 4/18/12 By DATE ATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By ' DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (April/2011) FPPC Toil -Free Helpline: 866/ASK-FPPC (866/275-3772)