Claire 09-19-1999 thru 10-16-1999 Special 490

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Officeholder, Ca ndidate, Type or print in ink. COVER PAGE- LONG FORM and Controlled Committee stata.,nt covers period Date Stamp Campaign Statement -- Long Form from (Government CodeSections84200-B4216.5, '//~/~/~ ~ ~ SEE INSTRUCTIONS ON REVERSE through / Check one of the following boxes to indicate the typa of statament being filed: Data of election if applical &l: OCT Pre-election Statement (M(mth, Day, Yelr) For Official Use Only Supplemental Pre-election Statement (Attach a completed Form 495 to this statement.) Special Odd-Year Campaign Report CITY OF REDWOOD CITY Semi-annual Statement /f~c:~T/~ ~_~ //~/~ CITY CLERK Termination Statement (Attach i completed Form 415 to this statement.) ate, Iill lis Statement commatees not Included in this comol/cLitedstatement that are controlled by you and any NAME OF OFFICE HOLDER OR CANDIDATE conun/ffues of which you have knowledge that are prtmadly formed to rece/ve contributions /~/ ~ r~/.~ ~ . ~__~ .~/~_ or lo mak, expenditures on behalf of rour candktKy. (WFICE SOUGHT O~ 14J. LD (eICLUOE LOCATION ANO DISTRICT NUMBER IF AllllLk~Li) COAMdlTTEE NAME I I.D. NUMIER I RESIDENTIAL Da BUSINESS ADD. SS ST,TE .,co,,, co--,',,,,,,,.ss ,.. AND, ,,T) COMMITTEE NAME I i.D. W)MIEA CITY STATE Zii) CODE ARL& CODEJi)AYTIME PttON~ I CO&IIdITTEE ADDIIESS (NO. ANO STREET) I I.D. NUMBER I NAME OF~///~p/./~.~TREASURER ~ CoMMmIE AIX~ESS (NO. AND I)E R&Ud)IENT ADOI~SS OF TREASUP, ER 0)10. J~JO STREET) CITY STATE Z~ CODE AREA COOFJDAYTIME IllfM)NE III verification I hive u.sed Ill .reasonable diligence in preparing this stltement. I have reviewed the statement and to the best of mylknowlecI~ the information contained herein ind in the attached Khedules is I true eno complete., I cattily under penalty of perjury under the laws of the State of California thlt the foreaoino is true end correct. ~ DATE CITY AND ST~i~I'E ~ / --KN~TURE OF TREASURER An officeholder or candidate who controls a committee must IIso ve,ify the campaign statement. I hive used ail reasonable diligence and to the best of my knowledge the treasurer has used all reasonable diligence in preparing this statement, i hive reviewed the statement end to the best of my knowledge the informa~n co/ntained J~ere)~Pend i.~the~ched schedules is true and complete. I certify u .nder ~enalty of perjury under the lam of the State of California ~lat the foregoing is true and correct// / /// DATE CIIY AND STATE ' MG~ATURE OF CAI~)IDATE/OfIICEHOLIXR Executed on At By DATE CITY AND STATE SIGN~TUP~ OF CANDIDATWEICEHOI. DEA Executed on At By DATE CITY AND STATE SIGNATURE OF CANDIDATE/OfFICEHOLDER FOR INFORMATION REoulIIED TO BE PROVIDED TO YOU PUIISUANT TO THE INIOILIdATION PRACTKES ACI OF 1977, SEE INtORMAIIQN MAN~IAL 4~)N CAMPAI(~N plSCLOSURE FROVlSK)N~i Of THE POLITICAl. R[I:~)RM A(~.