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Reci ientCommittee � . � � "`� covERPACE <br /> p Type or print in ink. � Date Stamp �� <br /> Campaign Statement k ' �. ' � • 1 <br /> Cover Page <br /> (Government Code Sections 84200-84216.5) `' J i���- � 1 2 0 j 2 pa 1 of 5 <br /> Statement covers period Date of election if ap�icable: <br /> from 1-1-12 (Month, Day,Yea�) ,,V,` , f For Ofrcial Use Only <br /> 1 " �� .-- <br /> SEE INSTRUCTIONS ON REVERSE through 6-30-12 �-��� ,.�,��,,.�,.�,�, . � <br /> 1. Type of Recipient Committee: no commm�eg-comp��ce Parts�,z,s,and 4. 2. 7ype of Statement: <br /> � Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement � Quarterly Statement <br /> Q State Candidate Eledion Committee Committee � Semi-annual Statement ❑ Special Odd-Year Report <br /> Q Recail Q Controlled Termination Statement <br /> (AlsoCompfetePartS) � Sponsored � ❑ SuppiementalPreelection <br /> (Also file a Form 410 Termination) Statement-Attach Form 495 <br /> (Also Complefe Part 6) <br /> ❑ General Purpose Committee ❑ Amendment(Expiain below) <br /> Q Sponsored � Primarily Formed Candidate/ <br /> Q Small Contributor Committee Officeholder Committee <br /> � Political Party/Central Committee {Also Complete Part 7) <br /> 3. Committee Information �•D. NUMBER Treasurer(s) <br /> 1253171 <br /> COMMITTEE NAME(OR CANDI�ATE'S NAME IF NO COMMITTEE} NAME OF TREASURER <br /> ROSANNE FOUST FOR CITY COUNCIL 2011 RICHARD S. CLAfRE <br /> MAILING ADDRESS <br /> SAME <br /> STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE <br /> <br /> CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY <br /> REDWOOD CITY CA 94062 <br /> MAILING ADDRESS (�F DIFFERENT) NO.AND STREET OR P.O.BOX MAILING ADDRESS <br /> CITY STATE ZIP CODE AREA CODElPHONE CITY STATE ZIP CODE AREA CODE/PHONE <br /> OPTIONAL: FAX!E-MAII ADDRESS OPTIONAL: FAX/E-MAIL ADDRESS <br /> 4. Verification <br /> I have used ail reasonable diligence in preparing and reviewing this statement and to the best of my k wledge the informati contained herein and in the attached schedules is true and complete. I certify <br /> under penalty of pery'ury un er th laws of the State of Califomia that the foregoing is true and corr <br /> Executed on Z By l ` <br /> Date Si otTreasureriprAssistantTreasurer <br /> ���� � �� � .. . <br /> EXecutedon �� By SignatureWConWNmgLlKceh �, eiWidate,State easureProponentorRespmsiWeOfficerofSpwisor <br /> Executed on By <br /> Date SignaWre ot Controbinq Oificeholder,Candidete,Stete Meas�xe Proparent <br /> Executed on BY <br /> Date SignaWre otConlroNing Otficehdder,Cantlidate,State Measure Proponent <br /> FPPC Portn 460(January105) <br /> FPPC Toll-Free Helpline:866/ASK-FPPC(86B/275-3T72) <br /> State of Califomia <br />