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COVER PAGE <br /> Recipient Committee Type or rint in ink. Date Stamp <br /> Campaign Statement p CAF RMNIA 460 <br /> Cover Page <br /> (Government Code Sections 84200-84216.5) Page; 1 of 16 <br /> Statement covers period Date of election if applicable: <br /> 1/1/2013 (Month, Day,Year) For Official Use Only <br /> from <br /> SEE INSTRUCTIONS ON REVERSE through <br /> 6/30/2013 11/5/2013 <br /> 1. Type of Recipient Committee: All committees-Complete Parts 1,2,3,and 4. 2. Type of Statement: <br /> ® Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure V Preelection Statement ❑ Quarterly Statement <br /> 0 State Candidate Election Committee Committee V Semi-annual Statement ❑ Special Odd-Year Report <br /> O Recall 0 Controlled ❑ Termination Statement ❑ Supplemental Preelection <br /> (Also Complete Pail 5) 0 Sponsored (Also file a Form 410 Termination) Statement-Attach Form 495 <br /> (Also Complete Part 6) ❑ Amendment(Explain below) <br /> ❑ General Purpose Committee <br /> O Sponsored ❑ Primarily Formed Candidate/ <br /> O Small Contributor Committee Officeholder Committee <br /> 0 Political Party/Central Committee (Also Complete Pail 7) <br /> 3. Committee Information I.D. NUMBER Treasurer(s) <br /> 1313963 <br /> COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER <br /> JOHN SEYBERT FOR CITY COUNCIL 2013 RICHARD S. CLAIRE <br /> MAILING ADDRESS <br /> <br /> STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE <br /> REDWOOD CITY CA 94062 <br /> CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY <br /> REDWOOD CITY CA 94062 <br /> MAILING ADDRESS (IF DIFFERENT) NO.AND STREET OR P.O. BOX MAILING ADDRESS <br /> CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE <br /> OPTIONAL: FAX/E-MAIL ADDRESS 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 kno ledge their • ma r•r containe• erein and in the attached schedules is true and complete. I certify <br /> under penalty of perjury under the laws of the State of Califomia that the foregoing is true and correct ,, /," <br /> �1 lC/ 'a/ L ` _ — , A' --.._Executed on � `/� By <br /> //r Date (, w... Signature of asurer orif"sista l <br /> Executed on Date _,By "�—re of Cone holder,Can•idate,S teM ure• •anent or'esponsible Officer of Sponsor <br /> Executed on By <br /> Date Signature of Controlling Officeholder,Candidate,State-Me.- re Proponent <br /> Executed on By <br /> Date Signature of Controlling Officeholder,Candidate,State Measure Proponent FPPC Form 460(January/05) <br /> FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) <br /> State of California <br />