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Recipient Committee <br /> Campaign Statement <br /> Cover Page <br /> (Government Code Sections 84200-84216.5) <br /> Type or print In ink. <br /> Statemsnt covera period <br /> from 10/21/07 <br /> SEE INSTRUCTIONS ON REVERSE I through 12/31/07 <br /> 1. Type of Recipient Committee: All Committees—Complete Parts 1,s,s,and 4. <br /> � Officeholder,Candidate Controlied Committee ❑ Primarily Formed Ballot Measure <br /> Q State Candidate Election Committee Committee <br /> Q Recall Q Controlled <br /> (A1soCompletePeR5) Q Sponsored <br /> ❑ GeneralPurposeCommittee (A/soCompletePart6) <br /> Q Sponsored � Primarily Formed Candidate! <br /> Q Small Contributor Committee Offlceholder Committes <br /> Q Pol�ical Party/Central Committee (A/soCompletaPaR7) <br /> 3. Committee Information <br /> COMMITTEE NAME (OR CANDIDATE'S NAME IF NO <br /> Committee to Elect lan Bain <br /> I.D. NUMBER <br /> STREET ADDRESS(NO P.O. BOX) <br /> <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> Redwood City CA 94061 <br /> MAILING ADDRESS (IF DIFFERENT) NO.AND STREET OR P.O. BOX <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> OPTIONAL: FAX I E-MAIL ADDRESS <br /> Date of electlon if appl <br /> (Month, Day, Year) <br /> 11/6/07 <br /> 2. Type of Statement: <br /> Date Stamp <br /> I� rl,� 'j 4� 1�(1 � r� <br /> � ��.^ �5 �: �,�i I_, � <br /> � <br /> �lal�� > � ��Q� �U <br /> CITY OF���7VVOUD CIl? <br /> � Preelection Statement <br /> ❑ Semi-annual Statement <br /> ❑ Termination Statement <br /> (Also file a Form 410 Termination) <br /> ❑ Amendment(Explain below) <br /> COVER PAGE <br /> Page_� of� <br /> For O�cial Use Only <br /> ❑ Quarterry Statement <br /> ❑ Special Odd-Year Report <br /> ❑ Supplemental Preelection <br /> Statement-Attach Form 495 <br /> Treasurer(si <br /> NAME OFTREASURER <br /> Lorianna Kastrop <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-MAII ADDRESS <br /> 4. Verification <br /> I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge th ' formation ntained herein and in the attached schedules is true and complete. I certify <br /> under penafty of perjury under the laws of the State of California that the foregoing is true and correct. <br /> Executed on J �� � � By �� <br /> Date Sipneture reasureror siatantTreaeuror <br /> Executed on �/��/6 � By _ <br /> Dete Signature of Conholling Otficeholder,Candidete,State Maesure Proponent or Responsible Officer M Sponaor <br /> Executed on <br /> Date <br /> Executed on <br /> Date <br /> By <br /> Signeture of CoMrolling Otticeholdar,Cendidete,Stete Measuro Proponent <br /> By <br /> SignatureMControllingOif�ceholder,Candidete,StetaMeasurePropwrent FPPC POrrt1460(JBnuary105) <br /> FPPC Toll-Free Helpline:8661ASK-FPPC(8661275-3772) <br /> State of Cailfornla <br />