Laserfiche WebLink
� ---tecipientCommittee r- 1 _ covE�s�� <br /> :amnaign Statement '�YPe or print in ink, oate S�amp � , <br /> � 6 <br /> :over Page � � � � �] � �1 � � <br /> 3ovemment Code Sections 84200-842165) <br /> Statement covers period oate ot e�ect�on ir aPp��can OCT `L `L ZUOB �' � Page � of <br /> ''. <br /> (Month, Day, Year) For Orciciai use Only <br /> from _I a—� ' 6 8 CITY OF RBDWOOD CITY <br /> '/- CITY CLEFK <br /> EE INSTRUC710N5 ON REVERSE through �O -��- D$ �Y J N - Z�O$' <br /> . Type of Recipient Committee: nu commimes-comoia�e aa�u �,:,s,a�a+. 2. Type of Statement: <br /> ❑ Offceholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement [] puarteAy SWtement <br /> QStateCandidateElectionComm�tee Committee ❑ Semi-annualStatement . � SpecialOdd-YearReport <br /> � Recalt Q Conholled � Tertninalion Statement � <br /> (asoca�crereaans) � Sponsored ❑ SupplementalPreelection <br /> (Also file a Form 41 Termination) Statemenl-Attach Form 495 <br /> �aso cwnpneaart e� <br /> � GeneralPurposeCommittee ❑ AmendmeN (Ezplain helow) <br /> Q Sponsored ❑ Primarily Fortned Candidate� <br /> QSmaIlContribuforCommittee OfficeholderCommidee , � <br /> � PoliticalParty/CentralCommittee �asocw.�ok�eaart�l <br /> •. Committee Information I.D. NUMBER Treasurer(s) ��f ,/,� <br /> I 3 O r/ ti/i¢iQ�/ /v/O/2 T E,✓S6� <br /> COMMITTEE NAME (OR CANDIDATE'S NAME IP NO COMMITTEE� NAME OF TREASURER <br /> Crrizr:ros 7-o n2o�ECr �cn�u000 � l�e%r, A / <br /> /� �4� MC}/o,v MAILING A��RESS <br /> y Gnr�.rii r-r�EE �7 � /f <br /> / �Z�asw 5 el . K4'Aw aov `-- �N l� `/1�062 � <br /> S�REET AODRESS (NO P.O. 80%) � CITV STATE 21P COOE AREA CODE/Ei�Vg <br /> icsDw000C�rv � S`�o62 ���°� <br /> CITV STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER. IF ANV <br /> l�. D. i3ox a. � �3 <br /> MAI ING A�DRE55 (IF DIFFERENT) NO. ANO STREET OR P.O. BOX MAILING AODRE55 <br /> 1�e� �.�ooD C'�7v C�- 9yob� <br /> CITY 57ATE ZIP CODE AREA CODE/PHpNE CITV STATE ZIP CODE AREA CODE/RMJSIQE <br /> OPTIONAL FA% I E�MAIL AODRESS OPTIONAC FA%/F-MAIL ADORE55 <br /> . Verification <br /> I have used all reasonable dilgence in preparing and reviewing Ihis statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. I cetfY�Jy <br /> under penalty of peryury under the laws of the State of Catifornia that the loregoing is true and w t. <br /> Ezecuted on �d'- aU - �� gy <br /> �e p�aNe of Treasurar o�Assu:mtireesurer <br /> Executetl on By <br /> Uae Sg�atureaf Conkalllrg pYicaNkle�_CanCitlaR.StatCMeawe Propo�+eN or Resoorai�leOtteer ot Sponsw <br /> Executed on By <br /> pga SpnaluraolGoMmllrp OPKtl+oldai.CaW date,Stete Maesve Propomrn <br /> Executed an By � <br /> �e SqnaNreolCornrolkqORCe�otler.CaMitlale,5�ateMaosuePropaenl FPPC Form d60(Janury�pQ� <br /> FPPC ToI6Free Helpline:866/ASK-FPPC(866�24ffiB7${ <br /> State of Cmtifmiti <br />