Redwood City Teachers Association PAC 04-20-2012 Initial State 410

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Statement of Organization l;�_3� Type or print in ink Recipient Committee Statement Type ® initial L ❑ Amendment Not yet qualified ❑ or List I.D. number: 4 / 10 / 12 r Date qualified as committee Date qualified as committee pf appicable) 1. Committee Information NAME OF COMMITTEE Redwood City Teachers Association Political Action Fund STREETADDRESS (NO P.O. BOX) 1235 McAllister St. #318 STATEMENT OF ORGANIZATION RE EI'VE&M FIL, '_ ' . 1 IR the Ill �itthhe State of California S • ❑ Termination -See Part5 For Official Use Only List I.D. number. APR 2 d 2012 Wend Dallvemdr 6201119% Date of Termination pviilm - i wen, seorstary 0 2. Treasurer and Other Principal Officers NAME OF TREASURER Sean Higgins STREETADDRESS (NO P.O. BOX) 1235 McAllister St. #318 CITY STATE ZIP CODE AREA CODE/PHONE San Francisco CA 94115 (415) 307-8205 CITY STATE ZIP CODE AREACODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY San Francisco CA 94115 (415) 307-8205 STREETADDRESS (NO P.O. BOX) MAILING ADDRESS (IF DIFFERENT) P.O. Box 610118 Redwood City, CA 94061 CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/E-MAILAomess - - -- ---- - - -- - - -- NAME OF PRINCIPAL OFFICER(S) COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT Bret Baird Seat n �r r+� In r r aSc o THAN COUNTY OF DOMICILE STREET ADDRESS (NO P.O. BOX ) 1 S d) 4 & 0 ct Y\ ✓�/t i 510 Driscoll Place CITY STATE ZIP CODE AREACODE/PHONE - - Attach additionai information on appropriately labeled continuation sheets. Palo Alto - CA 94306- - (650)255-2623 - ,- ----3. Verification - - --- --- --------------- --- ------ I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. 4/18/12 i Executed on By ! DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER Executed on 4/18/12 By P,,q0AWMRATU DATE RE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By - - DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 4111 (ApdI12611) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)