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Statement of Organization CALIFORNIA <br /> Recipient Committee FORM 410 <br /> INSTRUCTIONS ON REVERSE <br /> Page 2 <br /> COMMITTEE NAME <br /> I.D.NUMBER <br /> John Seybert for Redwood City Council 2013 'S>"S 9(0 <br /> • All committees must list the financial institution where the campaign bank account is located. <br /> NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER <br /> United American Bank (650)298-7000 041002494 <br /> ADDRESS CITY STATE ZIP CODE <br /> 2400 Broadway#100 Redwood City CA 94063 <br /> 4.Type of Committee Complete the applicable sections. <br /> Controlled Committee <br /> • List the name of each controlling officeholder,candidate,or state measure proponent. If candidate or officeholder controlled,also list the elective office sought or held,and <br /> district number,if any,and the year of the election. <br /> • List the political party with which each officeholder or candidate is affiliated or check"nonpartisan." <br /> • If this committee acts jointly with another controlled committee,list the name and identification number of the other controlled committee. <br /> NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD <br /> (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY <br /> © Nonpartisan <br /> John Seybert City Council 2013 <br /> ❑ Nonpartisan <br /> Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below: <br /> CANDIDATE(S)NAME OR MEASURE(S)FULL TITLE(INCLUDE BALLOT NO.OR LETTER) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION <br /> (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE <br /> SUPPORT OPPOSE <br /> s on <br /> FPPC Form 410(Dec/2012) <br /> FPPC Advice:advice @fppc.ca.gov(866/275-3772) <br /> www.fppc.ca.gov <br />