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p. Type or print in ink. Date Stamp . COVERPAGE <br /> Reci ient Committee <br /> Campaign Statement •' ' � � � <br /> Cover Page " ' <br /> (Government Code Sections 84200-84216.5) �� <br /> Statement covers period Date of election if applicable: ;.;, T -, �k "+��� , 1 7 <br /> (Month, Day,Year) ' �Li� ; Page of <br /> from 9/20/15 " °' ' <br /> � �� For Official Use Only <br /> SEE INSTRUCTIONS ON REVERSE th�0ugh 10/17/15 11�4�(15 � <br /> 1. Type of ReCipient Committee: A��committees-comp�ete Parts�,z,a,and 4. 2. Type of Statement: <br /> � Officeholder,Candidate Controiled Committee ❑ Ballot Measure Committee � Preelection Statement � Quarterly Statement <br /> Q State Candidate Election Committee Q Primarily Formed ❑ Semi-annual Statement � Speciai Odd-Year Report <br /> Q Recall Q Controlied <br /> ❑ Termination Statement <br /> (AlsoCanpletePartS) Q Sponsored ❑ Supplemental Preelection <br /> (AlsoCompletePaR6) ❑ Amendment(Explain below) Statement-Attach Form 495 <br /> ❑ General Purpose Committee <br /> � Sponsored ❑ Primarily Formed Candidate/ <br /> Q Small Contributor Committee Officeholder Committee <br /> Q PoliticalParty/CenValCommittee (AlsoCompletePart7) <br /> 3. Committee Information I.D. NUMBER Treasurer s <br /> 1376624 � � <br /> COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER <br /> Shelly Masur for Redwood City Council 2015 Shelly Masur <br /> MAILING ADDRESS <br /> 440 Birch Street <br /> STREET ADDRESS(NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE <br /> 440 Birch Street Redwood Ciry CA 94062 650-814-0349 <br /> CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY <br /> Redwood City CA 94062 650-814-0349 <br /> MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O. BOX MAILING ADDRESS <br /> CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE <br /> OPTIONAL: FAX!E-MAIL ADDRESS 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 knowledge the information contained herein and in the attached schedules is true and complete. I <br /> certify under penalty of pery'ury under the laws of the State of California that the foregoing is true and correct. <br /> Executed on ��� ��� �'� g (/��'� o✓� <br /> Y <br /> L�j� � � Sign Tre rorASSi�t�ntTre�surer <br /> Executed on � gy ����� <br /> � SignatureofControllingOfficehdder,Candidat,S teMeasureProponentorResponsibleOfficerofSponsa <br /> Executed on gy <br /> �� Signature ofControlling Officehdder,Candidate,State Measure Proponent <br /> Executed on <br /> �� By SignatureofConvollingOfficehdder,Candidate,ShateMeasureProponent FPPC Form 460(June/01) <br /> FPPC Toll-Free Helpline:866/ASK-FPPC <br /> State of California <br />