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R�cipient Committee T COVERPAGE <br /> ype or print in ink. ' <br /> Campaign Statement � _ � � • <br /> �over Page R E� E I V <br /> (Government Code Sections 84200-84216.5) 3 <br /> Statement covers period Date of election if applicable: Page of <br /> from <br /> 7/1/11 (Month, Day, Year) FEB 2 2��2 For rrciai use Oniy <br /> CITYOFfREDWOOD ITY <br /> SEEINSTRUCTIONS ON REVERSE thlOUgh �2�31/11 <br /> CI7Y CLERK <br /> 1. Type of Recipient Committee: nn comm�nees - comPie�e Parts �, z, s, a�a a. 2. Type of SWtement: <br /> � Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement � Quarterly Statement <br /> �StateCandidateElectionCommittee Committee � Semi-annualStatement � SpecialOdd-YearReport <br /> � Recall Q Controlled Termination Statement <br /> (AlsoCompletePaRSJ Q Sponsored � ❑ SupplementalPreeledion <br /> (Also f le a Form 410 Termination) Statement - Attach Form 495 <br /> (AlsnCompleteGart6J Amendment Ex lain below <br /> ❑ General Purpose Committee � � P � <br /> Q Sponsored � PrimarilyFOrmedCandidate/ <br /> Q Small Contributor Committee Officeholder Committee <br /> QPolilicalParty/CentralCommittee (AlsoCompletePart7) <br /> 3. Committee Information �.D. NUMBER Treasurens) <br /> 970913 <br /> COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER <br /> Friends of Jeff Ira Jeffrey Ira <br /> MAILING ADDRESS <br /> <br /> STREET A�DRESS (NO P.O. BOX) CITY STAlE ZIP CODE AREA CODE/PHONE <br /> Redwood City CA 94065 <br /> CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANV <br /> Redwood City, CA 94065 <br /> MAILWG ADDRESS QF �IFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS <br /> CITV STATE ZIP CODE AREA CODE/PHONE CITV STATE ZIP CODE AREA CO�E/PHONE <br /> OPTIONAL FAX / E-MAIL ADDRESS OPTIONAL PAX / EMAIL ADDRESS <br /> 4. Verification <br /> I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and wmplete. I certify <br /> under penalry of perjury under the laws of the State of Califomia that the foregoing is true and corred. <br /> Executetlon ��31/12 BY <br /> Dete naWreMTreas orASSisWntTreasurer <br /> F�cecutetl on By <br /> Date Signatve MCOntrolling OfficeMldar, Cantlitla�e, Sta�e Measure ProponeM a Responsible Olficer of Sponsa <br /> 6cewted on By <br /> Date SignaWreMContmlling Officehdder, Candida�e, S�a�e Measure Pmporient <br /> EXECUl2dOn Date BY SlgriaWreMCOMrolling0(lice�oWer,Cantlitlate,StateMeasurePropment FPPCFOm1460(Janualy/O5) <br /> FPPC Toll-Free Helpline: 866/ASKFPPC (866/2753772) <br /> State of California <br />