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COVER PAGE <br /> Recipient Committee Type or print in ink. Date Stamp <br /> Campaign Statement CALIFORNIA 460 <br /> Cover Page FORM <br /> Code Sections 84200-84216.5) FM71 1 e 1 of 5 <br /> Statement covers period Date of election if applicable: <br /> 10/18/09 (Month, Day,Year) FEB 0 1 2010 For Official Use Only <br /> from <br /> 12/31/09 11/3/09 CITY OF REDWOOD CITY <br /> SEE INSTRUCTIONS ON REVERSE through CITY CLERK <br /> r--- <br /> 1. Type of Recipient Committee: All Committees—Complete Parts 1,2,3,and 4. 2. Type of Statement: <br /> ® Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement <br /> O State Candidate Election Committee Committee VI Semi-annual Statement ❑ Special Odd-Year Report <br /> Q Recall 0 Controlled ❑ Termination Statement ❑ Supplemental Preelection <br /> (Also Complete Part 5) O Sponsored (Also file a Form 410 Termination) Statement-Attach Form 495 <br /> (Also Complete Part 6) <br /> ❑ General Purpose Committee ® Amendment(Explain below) <br /> Q Sponsored ❑ Primarily Formed Candidate/ CERTAIN AMOUNTS WERE INADVERTENTLY MISS <br /> Q Small Contributor Committee Officeholder Committee <br /> O Political Party/Central Committee (Also Complete Part 7) CLASSIFIED-SCHEDULE A,E &CONTIUATION SCHEDULE E. <br /> 3. Committee Information I.D. NUMBER Treasurer(s) <br /> 1313963 <br /> COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER <br /> JOHN SEYBERT FOR CITY COUNCIL 2009 RICHARD S. CLAIRE <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 (IF DIFFERENT) NO.AND STREET OR P.O. BOX MAILING ADDRESS <br /> CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE <br /> OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/E-MAIL ADDRESS <br /> 4. Verification <br /> I have used all reasonable diligence in preparing and reviewing this statement and to the best of knowledge the i formation contained herein and in the attached schedules is true and complete. I certify <br /> under penalty of perjury under the laws of the State of California that the foregoing is true and,co ct ? . 7 <br /> Executed on //Zef /� Byof f/` Zel ai /P. ssistantTreasurer <br /> Date 9 <br /> Executed on <br /> ,/ 2-0/D =4W /m • 4 now <br /> Date ignatuy on olling Office'•Ide C andidateNif easure Proponent or Responsible Officer of Sponsor <br /> Executed on By <br /> Date Signature of Controlling Officeholder,Candidate,State Measure Proponent <br /> Executed on By <br /> Date Signature of Controlling Officeholder,Candidate,State Measure Proponent FPPC Form 460(January/05) <br /> FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772) <br /> State of California <br />