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COVER PAGE <br /> Recipient Committee Type or print in ink. Date Stamp CALIFORNIA /� 6 0 <br /> Campaign Statement _ _; 2001/02 ' f'V <br /> Cover Page <br /> (Government Code Sections 84200-84216.5) - FORM <br /> Statement covers period Date of election if applicable: P>a e 1 of 6 <br /> 9/22/13 (Month, Day,Year) ,g <br /> from CU 2 1 2013 For Official Use Only <br /> SEE INSTRUCTIONS ON REVERSE through 10/19/13 <br /> 11/5/13 = <br /> 0 1 <br /> 1. Type of Recipient Committee: All Committees-Complete Parts 1,2,3,and 4. 2. Type of State ent: cri CLEP.K <br /> ® Officeholder,Candidate Controlled Committee ❑ Ballot Measure Committee ® Preelection Statement ❑ Quarterly Statement <br /> Q State Candidate Election Committee 0 Primarily Formed ❑ Semi-annual Statement ❑ Special Odd-Year Report <br /> Q Recall 0 Controlled Termination Statement <br /> (Also Complete Part 5) 0 Sponsored <br /> ❑ ❑ Supplemental Preelection <br /> (Also Complete ❑ Amendment(Explain below) Statement-Attach Form 495 <br /> Part❑ General Purpose Committee <br /> Q Sponsored ❑ Primarily Formed Candidate/ <br /> Q Small Contributor Committee Officeholder Committee <br /> Q Political Party/Central Committee (Also Complete Part 7) <br /> 3. Committee Information I.D. NUMBER 1313963 Treasurer(s) <br /> COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER <br /> JOHN SEYBERT FOR CITY COUNIL 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 64062 <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 • my knowled the information contained herein and in the attached schedules is true and complete. I <br /> certify under penalty of perjury under the laws of the State of California that the foregoin• ' and corr 11' <br /> Executed on /r ' 0 / By //e �� t <br /> Executed on J 26 3 By -../ V <br /> Signature of Cont. '•'1iceholder,Can.•.!e, r:=__ roponent or Responsble Officer of Sponsor <br /> Executed on By <br /> Date Signature of Controltng Officeholder,Candidate,State Measure Proponent <br /> Executed on By FPPC Form 460 <br /> Date Signature of Controlling Officeholder,Candidate,State Measure Proponent (June/01) <br /> FPPC Toll-Free Helpline:866/ASK-FPPC <br /> State of California <br />