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��^���� � g 4- nF� COVER PAGE <br /> Recipient Committee a Date Stamp •- . <br /> Campaign Statement � SEP 2 2 201 �� , � ' <br /> Cover Page Statement covers period Date of Election if applicabl Page of 23 <br /> from 07/O1/2015 f�!4�"`-����'�:-�-^'b'`"°�-� -.� For Offi I Use Only <br /> 11/03/2015 ��f°,'�•fr;:�_�f;:�( <br /> through 09/19/2015 (Month, Day, Year) m�° �zi� <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 /> 0 State Candidate Election Committee committee � Semi-Annual Statement � Special Odd-Year Statement <br /> � Recall Q 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 /> 3. Committee Information I I.D.Number 1377423 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 CODE/PHONE <br /> Burlingame CA 94010 <br /> CITY STATE ZIP CODE AREA CODEIPHONE NAME OF ASSISTANT TREASURER,IF ANY <br /> Redwood City CA 94062 Kirk Alan Pessner <br /> MAILING ADDRESS(IF DIFFERENT) STREEf ADORESS <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-MAIL ADDRESS <br /> ( / <br /> 4. Verification <br /> I have used all reasonable diligence in preparing and reviewing this statement and to the best of my wledge the information contained herein is true and <br /> complete. I certify under penalty of perjury under the laws of the f California that the forego' is true correct. <br /> Executed on 9/ ��15 By • <br /> SI�N OF T SUR R R AS I TANT TREASURER <br /> Executed on 9/ ��j15 By <br /> SIGNATURE 0 CONTR LLING OFFICEH LDER, A A7E,STATE MEASURE PROPONENT OR R SPONSIBLE OFFICER OF SPONSOR <br /> Executed on By <br /> SIGNATURE Of CONTROLLING OFFICEHOLDER,CANDIDATE,STATE MEASURE PROPONENT <br /> Executed on By <br /> SIGNATURE OF CONTR LLING OFFICEHOIDER,CANDIDATE,STATE MEASURE PROPON�I,�C Form 460-January105 <br /> State of California/SI <br />