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Recipient Committee <br />Campaign Statement <br />Cover Page <br />(Government Code Sections 84200- 84216.5) <br />SEE INSTRUCTIONS ON REVERSE <br />fro <br />Type or print In ink. <br />Statement covers period <br />m October 25, 2011 <br />through <br />December 31, 2011 <br />1. Type of Recipient Committee: All CommlBeea — Complete Parts 1, 2, a, and 4. <br />❑ Officeholder, Candidate Controlled Committee ® <br />Primarily Formed Ballot Measure <br />Q State Candidate Election Committee <br />Committee <br />Q Recall <br />Q Controlled <br />(Also Campleh Patt5) <br />Q Sponsored <br />❑ General Purpose Committee <br />(also COmplere Pans) <br />Q Sponsored ❑ <br />Primarily Formed Candidate/ <br />Q Small Contributor Committee <br />Officeholder Committee <br />Q Political Party/Central Committee <br />(Al.. Complete Pen]) <br />3. Committee Information D. NUMBER <br />1340190 <br />COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) <br />Redwood City Residents to Protect City Services <br />STREET ADDRESS (NO P.O. BOX) <br /> <br />CITY STATE ZIP CODE AREA CODE /PHONE <br />Redwood City CA 94062 <br />MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX <br />CITY STATE 21P CODE AREA CODE /PHONE <br />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 k <br />under penalty of perjury under the laws of the State of California that the foregoing is tue and correct. <br />Executed on January 3, 2012 <br />Dare <br />Executed on January 3,2012 <br />wre <br />Executed on <br />Executed on <br />Data <br />By <br />By <br />Date of election if ap Icable: FEB 1 2012 <br />(Month, Day, Ye 1 ) )Ty OF REDWOOD For omaal Use only <br />ary <br />November 8, 20 CITY CLERK <br />2. Type of Statement: <br />❑ Preelection Statement ❑ Quarterly Statement <br />® Semi - annual Statement ❑ Special Odd -Year Report <br />❑ Termination Statement ❑ Supplemental Preelection <br />(Also file a Form 410 Termination) Statement - Attach Form 495 <br />❑ Amendment (Explain below) <br />Treasuren(s) <br />NAME OF TREASURER <br />Nancy Radcliffe <br />MAILING ADDRESS <br /> <br />CITY STATE ZIP CODE AREA CODE /PHONE <br />Redwood City CA 94062 <br />NAME OF ASSISTANT TREASURER, IF ANY <br />MAILING ADDRESS <br />CITY STATE ZIP CODE AREA CODE /PHONE <br />OPTIONAL: FAX / E -MAIL ADDRESS <br />herein and in the attached schedules is true and complete. I certify <br />By <br />Signature dContmiling Oficehoker, CaMldere, Srere Measure P,wmnt <br />By <br />Signature of CorM011�ng Oa�hoHar, Cenrlitlele, Stafe Measure PmDOnaM <br />FPPC Form 460 (January105) <br />FPPC Toll -Free Helplins: 8661ASK -FPPC (8881275.5772) <br />State of California <br />