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This form must be used to amend statements filed pursuant to Government <br /> Code Sections 84200-84217, and must be filed with all filinc~ officers who <br /> rece ved the statement being amended. NOTE: This form ~s not used to <br /> amend a Statement of Organization (Form 410). To amend a Statement of <br /> CITY OF REDWOOD CITY <br /> Organization, use the Form 410. CITY CLERK <br /> <br />FORM 405 <br />1989 (Type or Print in Ink) <br /> FOR OFFICIAL USE ONLY <br /> A <br /> I. The information required in Section I must correspond to the information provided <br /> on the campaign statement. <br /> I.D. NO (IF APPLICABLE): <br />NAME ~LER: <br /> <br />ADD'RE ~S-OF FILER: NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE NUMBER <br /> <br />NAME OF TREASURER (IF APPLICABLE): <br /> <br /> PERMANENT ADDRES~ OF TREASURER (IF APPLICABLE): NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE NUMBER <br /> <br /> LO ' <br /> <br /> II. The following information amends campaign disclosure statement, Form No. 4~ ~ , Executed on <br /> <br /> (MO., DAY, YR.) <br /> <br /> III. The amended information affects items on the: <br /> [] Front Page [] Allocation Page ~Summary ~--~Scheduie(s) <br /> <br /> IV. Describe the changes below. Include in detail all information you wish to become a part of your official campaign <br /> statement. Also attach a new front page, summary or appropriate schedule if needed for clarification· <br /> <br /> Include additional information on reverse side or on appropriately labeled continuation sheets. (Number of pages attached ) <br /> VERIFICATION <br /> I HAVE USED ALL REASONABLE DILIGENCE IN PREPARING THIS STATEMENT. I HAVE REVIEWED THE STATEMENT AND TO THE BEST OF <br /> MY KNOWLEDGE THE INFORMATION CONTAINED HEREIN AND tN THE ATTACHED SCHEDULES IS TRUE ANO COMPLETE. <br /> I CERTIFY UNDER FI~NALI'Y OF PERJUR~F..I~OEI( THE LAWS OF-THE STATE OF,~.~kIFO~NIA~THAT TH~ FORE~u~IIJG~I~ TRUE AND CORRECT <br /> <br /> A CANDIDATE, OFFICEHOLDER OR STATE MEASURE PROPONENT WHO CONTROLS A COMMITTEE MUST ALSO VERIFY THE <br /> CAMPAIGli STATEMENT. <br /> IHAVE USED ALL REASONABLE DILIGENCE, AND TO THE BESTOF MY KNOWLEDGE. THE TREASURER HAS USED ALL REASONABLE <br /> DILIGENCE IN PREPARING THIS STATEMENT. IHAVE REVIEWED THE STATEMENT AND TO THLBEST OF MY KNOWLEDGE THE <br /> C I CERTII:Y UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF C T AN0 <br /> -- CORRECT. Y , <br /> · D EXECUTED ON AT <br /> <br /> F EXECUTED ON AT BY <br /> <br /> <br />