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Officeholder and Candidate SHORT FORM <br />Campaign Statement- Typ* Or print in iil~; <br />Short Form <br />(Government C~e Section 84206) Date of election if appli~ble: ~ Amendment (Explain Below) For ~[ Use Only <br /> (Mon~, Day, Year, <br /> <br /> II CITY OF REDWOOD CITY <br /> I/ CITY CLERK <br />1. Statement Covers Calendar Year 20 03 <br /> <br />2. Officeholder or Candidate Information 3. Office Sought or Held <br /> NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD <br /> Richard Claire Council Member/Mayor <br /> STREET ADDRESS JURISD~CTION (LOCATION) DISTRICT NUMBER <br /> I F APPLI CABLE) <br /> City of Redwood City <br /> Cl~ STATE ZIP CODE <br /> <br /> Redwood City CA 94062 <br /> AREA COD~DA~IME PHONE NUMBER ~ / E-MAIL ADDRESS <br /> <br /> <br />4. Commi~ee Information <br /> List al~ commi~ees of which you have knowledge that are prima~ly formed ~o receive contributions or to make expenditures on behaff of your candidacy. <br /> <br /> COMMI~EE NAME AND LD. NUMBER COMMI~EE ADDRESS NAME OF TREASURER <br /> <br />5. Verification <br /> I declare under penalty of perjury that to the best of my knowledge I anticipate that I will receive less than $1,000 and that I will spend less than $1,000 during <br /> the calendar year and that I have used all reasonable diligence in preparing this statement. I cedify under per~alty..of perjury' under the laws of the State of <br /> Cell fo mia that the fo re going is [,~,~_~ rue and co rre ct. ~~J~~~, <br /> Executed on J'~- ~' ~'- ~ By, <br /> DATE SIGNATURE OF OFFICEHOLDER OR CANDIDATE <br /> <br /> FPPC Form 470 (June/01) <br /> FPPC Toll-Free Helpline: 866/ASK-FPPC <br /> <br /> <br />