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Statement of Organization <br />REGENED <br />• <br />Recipient Committee <br />a <br />Statement Type ® Initial ❑ Amendment ❑ Termination — See P rt 6 <br />For Official Use Only <br />Q Not yet qualified <br />or <br />a Date qualification threshold met Date qualification threshold met <br />Date of termination City <br />of Redwood City <br />City Clerk <br />• I.D. Number <br />2. Treasurer and Other <br />Principal Officers <br />! o IIcvLla <br />NAME OF COMMITTEE <br />NAME OF TREASURER <br />Gordon Chu <br />L W Rr, 1)W D 0 b ("ITY C a lO NC L 121511btr <br />STREET ADDRESS (NO P.O. BOX) <br />j XE) <br />3049 Page Street <br />STREET ADDRESS (NO P.O. BOX) <br />CITY <br />STATE <br />ZIP CODE AREA CODE/PHONE <br />3049 Page Street <br />Redwood City <br />CA <br />94063 310-923-2401 <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />NAME OF ASSISTANT TREASURER, IF ANY <br />Redwood City CA 94063 650-207-2208 <br />0 <br />FULL MAILING ADDRESS (IF DIFFERENT) <br />STREET ADDRESS (NO P.O. Box) <br />Same as above. <br />f `1/ A <br />NA <br />NA <br />E-MAILADDRESS IREQUIRED}/FAX IOPTIONALI <br />CITY <br />STATE <br />ZIP CODE AREA CODE/PHONE <br />ichu4rwcd3@gmaii.com <br />N/ <br />COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE 15 ACTIVE <br />NAME OF PRINCIPAL OFFICERS} <br />San Mateo City of Redwood City <br />N A <br />STREET ADDRESS (NO P.O. BOX) <br />A <br />P1 <br />Attach additional information on appropriately labeled continuation sheets. <br />CITY #QA <br />STATE <br />Z{PCODE AREA CCDE/PHONE <br />3. Verification <br />1 <br />ave use a reasona le i Igence in preparing irlis statement ano to tine best o my nowls ge the Information contalne erein is true and comp ete. 1 certi y under <br />penalty of perjury under the laws of the State of Califo t t the forego i i rue and correct. ,ems � � t <br />Executed on 7_r_�1�/ �.�� By C-09DO � CHV <br />DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER <br />Executed on OATf By-%WA-_� QUA J <br />URE OF CON TROLLIN GOFFICEHOLDER, CAN DJDATE. OR STATE MEASURF PROPONENT <br />Executed on By <br />DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT <br />Executed on By <br />DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT <br />FPPC Form 410 (August/2018) <br />FPPC Advice: advice € c.ca.gov (866/275-3772) <br />WWw QV <br />