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COVER PAGE <br /> Recipient Committee Date Stamp <br /> Type or print in ink <br /> ampaign Statement CALIFORNIA CFORM 460 <br /> Cover Page <br /> (Government Code Sections 84200-84216.5) Page 1 of 11 <br /> Statement covers period Date of election if applicable: <br /> 7/1/2013 (Month, Day,Year} r, For Official Use Only <br /> from 4: <br /> SEE INSTRUCTIONS ON REVERSE through <br /> 9/21/2013 11/5/2013 <br /> 1. Type of Recipient Committee: All Committees Complete Parts:,2,3,and 4. 2. Type of Statelrent: <br /> ® Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ® Preelection Statement ❑ Quarterly Statement <br /> Q State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd-Year Report <br /> Q Recall 0 Controlled ❑ Termination Statement ❑ Supplemental Preelection <br /> (Also Complete Part 5) 0 Sponsored (Also file a Form 410 Termination) Statement-Attach Form 495 <br /> (Also Complete Part 6) r] Amendment(Explain below) <br /> Ell General Purpose Committee <br /> Q Sponsored ❑ Primarily Formed Candidate/ <br /> Q Small Contributor Committee Officeholder Committee <br /> O Political Party/Central Committee (Also Complete Part 7) <br /> I3. 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 CONUNCIL 2013 RICHARD S. CLAIRE <br /> MAILING ADDRESS <br /> <br /> STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE <br /> REDWOOD CITY CA 94062 <br /> CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY <br /> REDWOOD CITY CA 9406C <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 r-y knowled the• formation ntained 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 <br /> / <br /> 7,/ <br /> Executed on 9 By /`_ signer/ <br /> Executed on 3 By �' <br /> Signet ce""'Candidate,State Measure• ,•• • Responsible OfcerofSponsor <br /> Executed on By— <br /> Date Signature of Controlling Officeholder,Candidate,State Measure Proponent <br /> Executed on Date By <br /> Signature of Controlling Officeholder,Candidate,State Measure Proponent <br /> FPPC Form 460(January/05) <br /> FPPC Toll-Free Helpline:8661ASK-FPPC(8661275-3772) <br /> State of California <br />