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<br />Statement of Organization <br />Recipient Committee <br /> <br />STATEMENT OF ORGANIZATION <br /> <br />INSTRUCTIONS ON REVERSE <br /> <br />CALIFORNIA 41 0 <br />FORM <br /> <br /> <br />p' ao g, eo 3 <br /> <br />COMMITTEE NAME <br />Redwood City Residents, Teachers, Nurses, Firefighters, Police Officers, Seniors, Union Members, Businesses, and Citizens Committee for Marina Shores Village, <br />tanned and funded by Glenborouah Pauls. LLC <br /> <br />I.D. NUMBER <br /> <br />4. Type of Committee <br /> <br />(Continued) <br /> <br />General Purpose Committee <br /> <br />Not formed to support or oppose specific candidates or measures in a single election. Check only one box: <br />0 CITY Committee 0 COUNTY Committee 0 STATECommittee <br /> <br />PROVIDE BRIEF DESCRIPTION OF ACTIVITY <br /> <br />Sponsored Committee <br /> <br />List additional sponsors on an attachment. <br /> <br />NAME OF SPONSOR <br /> <br />INDUSTRY GROUP OR AFFILIATION OF SPONSOR <br /> <br />NO. AND STREET <br /> <br />CITY <br /> <br />STATE <br /> <br />ZIP CODE <br /> <br />STREET ADDRESS <br /> <br />Small Contributor Committee <br /> <br />0 -----1-----1- Check box and provide the date this committee qualified as a small contributor committee. If the committee qualified as a <br />Date qualified small contributor committee on January 1, 2001, enter 1/1/01. <br /> <br />5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that all ofthe following conditions have been met: <br /> <br />. This committee has ceased to receive contributions and make expenditures; <br />. This committee does not anticipate receiving contributions or making expenditures in the future; <br />. This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; <br /> <br />. This committee has no surplus funds; and <br />. This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. <br /> <br />-- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to <br />Government Code Section 89519. <br /> <br />FPPC Form 410 (Jan/03) <br />FPPC Toll-Free Helpline: 866/ASK-FPPC <br />