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COVER PAGE <br />,Recaplent Committee Type or print in ink, Da~e Stamp <br />Campaign Statement <br /> <br /> Statement covers period Date of election if; Page / of <br /> from ~"1,.) I V i . I ~ ~'i ~ (Month, Day, Year) ',.~ 3 .~ ~ For Omcla, Use Only <br /> <br />SEE INSTRUCTIONS ON REVERSE th rougl~~ CITY OF REDWOOD CiTY <br /> CITY CLERK <br /> <br />1. Type of Recipient Committee: AIIComrnittees-CompleteParts 1,2,3, andT. 2. Type of Statement: <br /> []~'~fliceholder, Candidate [] Primarily Formed Candidate/ [] Pre-election Statement [] Quarterly Statement <br /> Controlled Committee Officeholder Committee [~'~emi-annual Statement [] Special Odd-Year Report <br /> (Also Complete Part 4.) (Also Complete Part 6.) [] Termination Statement [] Supplemental Pre-election <br /> [] Ballot Measure Committee [] General Purpose Committee [] Amendment (Explain below) Statement - Attach Form 495 <br /> O Primarily Formed O Sponsored <br /> O Controlled O Broad Based <br /> O Sponsored <br /> (Also Complete Part 5.) <br /> <br /> I I.D. NDMBER <br />3. Committee Information i_T-.-/~z.~, j ~L~ + Treasurer(s) <br /> COMMI]TEE NAME NAME OF TREASURER <br /> <br /> STREET ADDRESS (NO P.O. BOX) CITY STATE ZiP CODE AREA CODE/PHONE <br /> CITY STATE ' ZIP COOE ...__.) AREA CODE/P HONE NAM E OF ASSISTANT TREASURE'R, IF ANY <br /> <br /> MAILING ADDRESS (IF DIFFE RENT~/N O. ED STREET OR P.O. BOX ' MAILING ADDRESS <br /> <br /> CITY STATE ZIP COOE AREA CODF-./PHONE CITY STATE ZIP COOE AREA CODE/PHONE <br /> <br /> OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/E-MAILADDRESS <br /> <br /> FPPC Form 460 (8/99) <br /> For Technical Assistance: 916/322-5660 <br /> State of C~lifornia <br /> <br /> <br />