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COVER PAGE - LONG FORM <br />Recipient Committee F~ ~ <br />Campaign Statement L~ ~ ~_~ ~ ~ <br /> <br />(Govemment Code Se~ions 84200- ~216.5) JAN 2 3 2004 <br /> S~c~em~ D~E~n~: CiTY 0F ~'.~ ~:~ Gl A For Official Use Only <br /> C~ ~ Y ..... RK <br /> ~ 01/01/2004 (~, ~,Y~ <br /> ~h 0;/~?/~o0~ 03/0~/200~ <br /> <br />1. Type of Recipient Commi~ee: 2. Type of S~tement: <br /> ~ ~ceholder, Candidate Controlled Commi~ee ~ Ballot Measure Committee ~ Pre~lection Statement ~ QuaAeHy S~tement <br /> ~ State Candidate Ele~ion Committee O P~marily Foxed ~ Semi-annual Statement ~ Special Odd-Year RepoA <br /> O Recall O Controlled ~ Termination Statement ~ Supplemental Pre-election <br /> O Sponsored ~ Amendment (Explain below) Statement - Attach Form 495 <br /> ~ General Purpose Committee <br /> O Sponsored ~ P~marily Foxed Candidate <br /> O Small ContHbutor Committ~ O~ceholder Commi~ee <br /> O Political Pa~y/Central Committee <br /> <br /> "~'"""~" Treasurer(s) <br />3. Commiffee Info~ation z~s~.0~ <br /> <br /> 1001 Iris Street Cl~ STATE ZIPC~E AR~CODE~HONE <br /> <br /> San Jose CA 95113 (408) 297-3795 <br /> <br /> Redwood City CA 94061 (650)261-1410 NAMEOF~SISTANTTRE~URER, IFANY <br /> <br /> ) <br /> <br /> ( 650 ) 365 - 7210 / O~IONAL: F~E-MAIL ADDRESS <br /> <br />4. Verification <br /> t have used all reasonable diligen~ in preparing and revie~ng this s~tement and to the best of my knowledge the info~ation ~ntained ~rein and ~the at~ched schedules <br /> is tree and ~mplete. I ce~i~ under penalty of ~duu under the laws of the S~te of California that the foregoing is t~e and co~ect. R~ ~ <br /> <br /> Exec~ed on //~~ By ~~ '~-- ~ ' ~ OF SP~SOR <br /> <br /> Exec~ed on By <br /> Exec~ed on By <br />S/CCW - PCAB05 01380 (Rev. 9~9) S~te of California Fair Political Practices Commission. <br /> <br /> <br />