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� <br /> Recipient Committee <br /> Campaign Statement <br /> Cover Page <br /> (Government Code Sections 84200-84216.5) <br /> Type or print in ink. <br /> Statement covers period Date of election if appli <br /> 1/1/04 (Month, Day,Year) <br /> from <br /> SEE INSTRUCTIONS ON REVERSE I through 6�3���4 <br /> 1. Type of Recipient Committee: All Committees—Complete Parts 1,s,s,and 4. <br /> � Officeholder,Candidate Controlled Committee ❑ <br /> �State Candidate Election Committee <br /> Q Recall <br /> (Also Complete Part 5) <br /> ❑ General Purpose Committee <br /> � Sponsored <br /> Q Small Contributor Committee <br /> �Political Party/Central Committee <br /> Bailot Measure Committee <br /> Q Primarily Formed <br /> � Controlled <br /> Q Sponsored <br /> (Also Canplete Part 6J <br /> � Primarily Formed Candidate/ <br /> Officeholder Committee <br /> (Also Canplete Part 7J <br /> 3. Committee Information I.D. NUMBER <br /> 1255762 <br /> COMMITTEE NAME(OR CAND�DATE'S NAME IF NO COMMITTEE) <br /> Committee to Elect lan Bain <br /> STREET ADDRESS(NO P.O. BOX) <br /> <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> Redwood City CA 94063 <br /> MAILING ADDRESS(IF DIFFERENT)NO. AND STREET OR P.O. BOX <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> ,�,UG i �� ?0(i4 <br /> TY OF REDWOOD CITY <br /> CITY CLERK <br /> 2. Type of Statement: <br /> ❑ Preelection Statement <br /> � Semi-annual Statement <br /> ❑ Termination Statement <br /> ❑ Amendment(Explain below) <br /> COVER PAGE <br /> of 2-�` <br /> For Official Use Only <br /> ❑ Quarterly Statement <br /> ❑ Special Odd-Year Report <br /> ❑ Supplemental Preelection <br /> Statement-Attach Forrn 495 <br /> Treasurer(s) <br /> NAME OF TREASURER <br /> Nancy Bain <br /> MAILING ADDRESS <br /> <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> Redwood City CA 94063 <br /> NAME OF ASSISTANT TREASURER, IF ANY <br /> MAILING ADDRESS <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/E-MAIL ADDRESS <br /> ian @ ianbain.com <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 perjury under the laws of the State of California that the foregoing is true and co�et� _ <br /> F�cecuted on 7�31/04 <br /> Date <br /> Executed on <br /> 7/31/04 <br /> Date <br /> Executed on <br /> Date <br /> By <br /> By <br /> By <br /> SignaNre o!Controlling Officehdder,Candidate,Sfate Measure Proponent <br /> Executed on BY FPPC Form 460 June/01 <br /> Date Signalure of Controllirg Officehdder,Candida[e,State Measure Proponent � � <br /> FPPC 7oll-Free Helpline:866/ASK-FPPC <br /> State of California <br />