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_ _ i <br /> COVER PAGE • <br /> Recipient Committee �'��� �'' ' i � � <br /> Campaign Statement <br /> Cover Page Statement covers period Date of Election if applicabl �U� 2 Q 201 Page of 10 <br /> from O 1/O 1/2 015* For Offi al Use Only <br /> ii/o3/2ois CITYpF RFDWQrJp ClTY <br /> * Qualified as Committee OS/OB/2015 th�ough 06/30/2015 (MOnth, Day, Year) <br /> CITY CLERK <br /> 1. Type of Recipient Committee 2. Type of Statement <br /> � Officeholder,Candidate Controlled Committee � Primarily Formed Ballot Measure � Pre-election Statement � Quarterly Statement <br /> � State Candidate Election Committee Committee � Semi-Annual Statement � Special Odd-Year Statement <br /> � Recall � Controlled � Termination Statement ❑ Supplemental Pre-election <br /> � General Purpose Committee � Sponsored ❑ Amendment Statement-Attach Form 495 <br /> � Sponsored Primarily Formed Candidate/ <br /> � Small Contributor Committee � Officeholder Committee <br /> � Political Party/Central Committee <br /> I.D.Number 1377423 <br /> 3. Committee Information Treasurer(s) <br /> COMMITTTEE NAME NAME OF TREASURER <br /> Rosanne Foust for City Council 2015 Russell Miller <br /> STREETADDRESS <br /> <br /> STREET ADDRESS(NO PO BOX) CITY STATE ZIP CODE AREA CODEIPHONE <br /> Burlinqame CA 94010 <br /> ��n' STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY <br /> Redwood City CA 94062 Kirk Alan Pessner <br /> MAILING ADDRESS(IF DIFFERENT) STREET ADDRESS <br /> <br /> CITY STATE ZIP CODE CITY STATE ZIP CODE AREA CODFJPHONE <br /> Burlingame CA 94010 <br /> OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/E-MAI�ADDRESS <br /> 4. Verification <br /> I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein is true and <br /> complete. I certify under penalty of perjury under the laws of the State o ia that the • ing is e and correct. <br /> Executed on a�� � � i 1 s By • <br /> S ATUR� F URE R I ANTTREASURER <br /> Executed on 07/ �� /15 By �� <br /> SIGNATURE OF CONTROLLI G ICEHOLDER,CA DIDATE,S TE MEASURE PROPONENT OR RESP NSIBLE OFFICER OF SPONSOR <br /> Euecuted on By <br /> SI NATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,STATE MEASURE PROPONENT <br /> Executed on By <br /> SIGNATURE F CONTROLLING OFFI EHOLDER,CANDIDATE,STATE MEASURE PROPONFf�I,�,C Form 460•January/OS <br /> State of California/SI <br />