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Statement of Organization <br />Recipient Committee <br />Statement Type ❑ Initial <br />Q Not yet qualified <br />or <br />O Date qualified as committee <br />❑ Amendment <br />12 3 ( 2008 <br />Dale qualified as committee <br />1. Committee InformationI I.D. Number <br />(if applicable) 1313963 <br />NAME OF COMMITTEE <br />JOHN SEYBERT FOR CITY COUNCIL 2013 <br />is Termination—See Par 6 <br />STREET ADDRESS (NO P.O. BOX) <br />244 ALAMEDA DE LAS PULGAS <br />CITY STATE ZIP CODE AREACODE/PHONE <br />REDWOOD CITY CA 94062 650-365-6794 <br />MAILING ADDRESS IIF DIFFERENT) <br />E-MAIL ADDRESS (REQUIRED) / FAx (OPTIONAL) <br /> <br />CO UNTY OF DO MICI LEIU RISDICTION WHERE COMMITTEE 15 ACTIVE <br />SAN MATEO REDWOOD CITY <br />7( 18 ( 2018 <br />nate of termination <br />u,Ve ...... <br />RECEIVED <br />JUL 2 3 2018 <br />:amity of Redwood City <br />2. Treasurer ana vcner rrntfpai J9S�rr� <br />111101:4 kil 1111111115' <br />For Official Use Only <br />NAME OF TREASURER <br />RICHARD S. CLAIRE <br />STREET ADDRESS (NO PO. BOX) <br />244 ALAMEDA DE LAS PULGAS <br />CITY STATE ZIP CO DE AREA CO DE/PHONE <br />REDWOOD CITY CA 94062 650-365-6794 <br />NAME OF ASSISTANT TREASURER, IF ANY <br />STREETADORESS(NO PO BOX) <br />CITY STATE ZIP CODE AREA COD E/PHONE <br />NAME OF PRINCIPAL OFFICER(S) <br />STREET ADORES$ (NO PO. BOX) <br />Attach additional information on appropriately labeled continuation sheets. CITY STATE ZIP COVE AREA CODE/PHONE <br />3. Verification <br />I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under <br />penalty of perjury under the laws of the State of If nia at t e f ing is true andd cdct. <br />Executed on 7/18/2018 By <br />GATEr NAT RE� ASSISTANTTREASURER <br />Executed on ti13 <br />By DAT GNATURE OF CO LLI FFICEHOI Efl,CANDIDATE, OR STATE MEASURE PROPONENT <br />Executed on By <br />DATE <br />Executed on By <br />DATE <br />SIGNATURE OF CONTROLLING <br />MEASURE PROPONENT <br />SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT <br />FPPC Form 410 (February/2018) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />