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Ret;i ientCommittee CAVERPAGE <br /> P Type or print in ink. Date Stamp <br /> Campaign Statement ' ��' � � • 1 <br /> Cover Page � I,y (�,�J�� � . <br /> (Government Code Sections 84200-84216.5) � <br /> IStatement covers period Date o( election it applicable: ,�UL 3 O Z003 � �f� <br /> from { �� � Q3 (Month, Day, Year) � <br /> For Olficial Use Only <br /> C!?`f OF REDWOOD ITY <br /> SEE MStRUC710NS ON REVERSE through C'� � '3O"G� _ fl��v3 CiTY CLERK <br /> 1. Type of Recipient Committee: nu commmees-comPie�e rarts�,z,a,aoa a. 2. Type of Statement: <br /> � Officeholder,Candidate Controlled Commitlee ❑ Balbt Measure Committee � Preelection Statement � puaAerly StatemeN <br /> Q State Candidate Eleclion Committee Q Primanly Formed � Semi-annual Statement � Special Odd-Year Report <br /> Q Recall � Conirolled Tertnination Statement � <br /> (AlsoCamplefePartS) � Sponsored � ❑ SupplementalPreeledion <br /> (AlsoCOmpleteParts/ ❑ Amendment(Explainbelow) Sta�ement-Attachform495 <br /> ❑ General Purpose Committee <br /> Q Sponsored � Primarily Formed Candidate/ <br /> Q Small ContributorCommittee Officeholder Committee <br /> QPoliticalParty/CentralCommittee (AlsoCanO�elePartJj <br /> 3. Committee Information I.D. NUMBER Treasurer(s) <br /> COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER <br /> RoSANKE FodST Fer,t2 C/ty�'qc;hlC/L R I P�k1aRfl 5 . C�J..Al2�c' — <br /> <br /> <br /> STREET ADDRESS (NO P.O. BOX) CITV STATE 21P CODE AREF CODE/PHONE <br /> I ����T�� 9AQ�oZ !�- <br /> CITV STATE ZIP CODE AfiEA CODE/PHONE NAME OF ASSISTANT TREA UREfl, IF ANV <br /> R�s�vD Gr� G�, 94[�z �,- <br /> MAILING ADDRESS (IF DIFFER NT) NO.AND STREET Ofi PO. BO% MAILING ADDqESS <br /> CITY � STATE ZIP CODE AREA CODE/PHONE CRV STATE ZIP CODE AREA CODE/PHONE <br /> OPTIONAL: FAX/E-MAIL A�DRESS OPTIONAL: FAX/E-MAIL ADDflE$5 <br /> 4. Verification <br /> I have used all reasonable 'igence'n preparing and reviewing this statement and to the best wle e e ' ormati o d herein and in the attached schedules is true and complete. I <br /> certify under penalty of p ury un r ihe laws of the State of Califomia ihat the toregoin � ir d corr c � <br /> Executed on � By ' <br /> Date SgnaWr oiTreasureror sistantTreasurer <br /> Executed on__�y�% • �By <br /> � Date Sig�alureMCOnlmlling011icaho'deqCandida�e.S�aleM ewreProponenlorResponsibleOHicerol5ponsa <br /> Exacuted on By <br /> Date SignaWred ConV011ing OXicehoMer,CanOAe�e,Sule Measure Proponml <br /> Executed on BY FPPC form 460 Jund01) <br /> . Dete SgnaWredCOnwlingOHiceM1Oldc,Candtlale,SIa�eMeawreProponem ( <br /> ' FPPC Toll-Free Helpline:866/ASK-FPPC <br /> Stete of Celifornia <br />