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Recipient Committee <br />Campaign Statement <br />Cover Page <br />(Government Code Sections 84200-84216.5) <br />SEE INSTRUCTIONS ON REVERSE <br />Type or print in ink. <br />Statement covers period <br />from 01/01/2021 <br />through 01/29/2021 <br />1. Type of Recipient Committee: All Committees - complete Parts t, 2, s, and 4. <br />® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure <br />M State Candidate Election Committee Committee <br />O Recall O Controlled <br />(Also Complete Part 5) O Sponsored <br />(Also Complete Part 6) <br />❑ General Purpose Committee <br />O Sponsored <br />0 Small Contributor Committee <br />O Political Party/Central Committee <br />3. Committee Information <br />❑ Primarily Formed Candidate/ <br />Officeholder Committee <br />(Also Complete Part 7) <br />I.D. NUMBER <br />COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) <br />Jason Galisatus for Redwood City Council 2022 <br />STREET ADDRESS (NO P.O. BOX) <br />518 Hillside Road <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />Redwood City CA 94062 650-521-1772 <br />MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />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 my k <br />under penalty of perjury under the laws of the State of California that the foregoing is true and corr%t. <br />Executed on 01/29/2020 <br />Date <br />Executed on 01/29/2020 <br />Date <br />Executed on <br />Dale <br />Date of election if applicab <br />(Month, Day, Year) <br />11/01/2022 1 <br />Date Stamp <br />'6 V is 1 Irl K <br />JAN 2 g 2021 15 <br />Page <br />CITY OF REDWOOD CITY <br />2. Type of Statement: <br />❑ Preelection Statement <br />❑ Semi-annual Statement <br />Termination Statement <br />(Also file a Form 410 Termination) <br />❑ Amendment (Explain below) <br />COVER PAGE - <br />1 of 14 <br />For Official Use Only <br />❑ Quarterly Statement <br />❑ Special Odd -Year Report <br />❑ Supplemental Preelection <br />Statement - Attach Form 495 <br />Treasurer(s) <br />NAME OF TREASURER <br />Cindy Galisatus <br />MAILING ADDRESS <br />518 Hillside Road <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />Redwood City CA 94062 650-780-0255 <br />NAME OF ASSISTANT TREASURER, IF ANY <br />MAILING ADDRESS <br />CITY <br />OPTIONAL: FAX / E-MAIL ADDRESS <br />STATE ZIP CODE AREA CODE/PHONE <br />contained herein and in the attached schedules is true and complete. I certify <br />Measure Proponent or Responsible <br />Executed on By <br />Date Signature of Controlling Officeholder, Candidate, StateMeasureProponent FPPC Form 460 (January/05) <br />FPPC Toll -Free Helpline: 866/ASK-FPPC (86612753772) <br />Stat. of (:alif—ia <br />By <br />\ J <br />B y <br />Stere oiCa <br />• By <br />- <br />Date of election if applicab <br />(Month, Day, Year) <br />11/01/2022 1 <br />Date Stamp <br />'6 V is 1 Irl K <br />JAN 2 g 2021 15 <br />Page <br />CITY OF REDWOOD CITY <br />2. Type of Statement: <br />❑ Preelection Statement <br />❑ Semi-annual Statement <br />Termination Statement <br />(Also file a Form 410 Termination) <br />❑ Amendment (Explain below) <br />COVER PAGE - <br />1 of 14 <br />For Official Use Only <br />❑ Quarterly Statement <br />❑ Special Odd -Year Report <br />❑ Supplemental Preelection <br />Statement - Attach Form 495 <br />Treasurer(s) <br />NAME OF TREASURER <br />Cindy Galisatus <br />MAILING ADDRESS <br />518 Hillside Road <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />Redwood City CA 94062 650-780-0255 <br />NAME OF ASSISTANT TREASURER, IF ANY <br />MAILING ADDRESS <br />CITY <br />OPTIONAL: FAX / E-MAIL ADDRESS <br />STATE ZIP CODE AREA CODE/PHONE <br />contained herein and in the attached schedules is true and complete. I certify <br />Measure Proponent or Responsible <br />Executed on By <br />Date Signature of Controlling Officeholder, Candidate, StateMeasureProponent FPPC Form 460 (January/05) <br />FPPC Toll -Free Helpline: 866/ASK-FPPC (86612753772) <br />Stat. of (:alif—ia <br />