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~~ ThJs form must be used to amen~ statements filed pursuant to , ~, <br />~' "amend a Statement <br /> .. Code Sections 84200-84216.5. and must be filed with all filing officers who <br /> ~/ received the statement being amended. NOTE: This form is not used to <br />of Organization (Form 410). To amend a Statement of <br />Organization, use. the Form 410. U .... CITY? -Clf. R~ <br /> FORM 405 (Type or Print in Ink) <br /> -' FOR OFFICL&L US[ ONLY <br /> <br /> I. The information required in Section I must correspond to the information provided <br /> on the campaign statement. <br /> I.D. NO. (IF APPLIC.ABLE); <br /> NAME OF FILER: (See important mlorm&tlon on reverse ) <br /> 880343 <br /> Judy Buchan <br /> /~,RAILING ADDRESS OF FILER; NO AND STREET CITY STATE ZIP CODE AREA CODE/PHONE NUMBER <br /> Redwood City CA 94063 ( <br /> <br /> NAME OF TREASURER IF RECIPIENT COMMITTEE: <br /> <br /> Dorothy Buchan <br /> PERMANENT ADDRESS OF TREASURER (IF APPLICABLE): NC). AND STREET CITY STATE ZIP CODE AREA CODE/PHONE NUMBER <br /> Redwood City CA 94063 ( <br /> <br /> II. The following information amends campaign disclosure statement. Form No. 490 , Executed on <br /> <br /> IMO. DA,. YR.) <br /> <br /> III. The amended information affects items on the: <br /> [] Summary Page <br /> [] Cover Page [] Allocation Page , <br /> <br /> r-'} Schedule(s) r-'] Part(s) <br /> <br /> IV. De,tribe the changes below. Include in detail all information, you wish to become a part of your official campaign <br /> statemenL Also a~ach a ~over page, summary page or appropriate schedule if needed for clarification. <br /> <br /> Math; corrections <br /> <br /> Include additional information on appropriately iabelec~ contmuat~on sheetS {Number of Dec)es at~ached ) <br /> V~RIFI~ON <br /> I HAVE'USED ALL REASONABLE DILIGENCE IN PREPARING THIS STATEMENT I HAVE REVIEWED THE STATEMENT AND TO THE BEST OF MY <br /> KNOWLEDGE THE INFORMATION CONTAINED HEREIN AND IN THE A~ACHED SCHEDULES IS TRUE AND COMPLETE. <br /> I CERTIFY UN~ER PE~AL~ OF P,ERJURY~NOER THE~W~OF THE STATE~LIFOR~t~HAT THE FOREGOING IS TRUE AND CORRECT <br /> <br /> A ~N~AT[, OFF~EHOLDER OR STATE ~EASURE ~O~NENT WHO CONSOLS A CO~[[ ~5T A~O VE~FY THIS <br /> I HAV~ USeD ALL REASONABL~ DILIGENCE. AND TO THE BEST OF MY K~WLEDGE. THE TREASURER HAS USED ALL REASONABLE <br /> DILIGE~E IN PREPARING THIS STATEMENT ~ HAVE REVtEWED THE STATEMENT ANO TO THE BEST OF <br /> IN~R~T~N CONTAINED HEREIN AND IN THE A~ACHED SCHEDULES IS TRuE AND COMPLETE. <br /> C <br /> <br /> 0 EXECUTED O~ <br /> E EXECUTED ON AT <br /> <br /> EXECUTED ON ~T <br /> lO. IL) IO11 ~ %l~l[) (~G~U~ ~ <br /> <br /> <br />