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Recipient Committee <br />Campaign Statement <br />Cover Page <br />(Government Code Sections 84200-84216.5) <br />SEE INSTRUCTIONS ON REVERSE <br />Type or print in ink. <br />Statement covers period <br />from 07/01 /06 <br />through <br />12/31 /06 <br />1. Type of Recipient Committee: All commineas -complete Parts ~, z, s, and a. <br />® Officeholder, Candidate Controlled Committee ^ Primarily Formed Ballot Measure <br />Q State Candidate Election Committee Committee <br />Q Recall Q Controlled <br />(Also CompletePaRS) ~ Sponsored <br />(Also Complete Part 6) <br />^ General Purpose Committee <br />Q Sponsored ^ Primarily Formed Candidate/ <br />Q Small Contributor Committee Officeholder Committee <br />Political Party/Central Committee (Alsocomp/ereFart7) <br />3. Committee Information I.D. NUMBER <br />970913 <br />COMMITTEE NAME (OR CANDIDATE'S NAME <br /> OF JEFF IRA <br />STREET P. O. BOX) <br />333 TWIN DOLPHIN DRIVE, SUITE 230 <br />CITY STATE ZIP CODE AREA CODEIPHONE <br />REDWOOD CITY, CA 94065 650-802-8668 <br />MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P. O. BOX <br />CITY <br />STATE ZIP CODE AREA CODE/PHONE <br />OPTIONAL: FAX / E-MAIL ADDRESS <br />Date of election if applicable: <br />(Month, Day, Year) <br />2. Type of Statement <br />Date Stamp <br />COVER PAGE <br />Page 1 of 3 <br />For Official Use Only <br />^ Preelection Statement ^ Quarterly Statement <br />® Semi-annual Statement ^ Special Odd-Year Report <br />^ Termination Statement ^ Supplemental Preelection <br />(Also file a Form 410 Termination) Statement -Attach Form 495 <br />^ Amendment (Explain below) <br /> <br />Treasurer(s) <br />NAME OF TREASURER <br />JEFFREY IRA <br />MAILING ADDRESS <br />SAME <br />650-802-8668 <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />NAME OF ASSISTANT TREASURER, IF ANY <br />MAILING ADDRESS <br />CITY STATE ZIP CODE AREA CODEIPHONE <br />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 knowledge the information contained herein and in the attached schedules is true and complete. I certify <br />under penalty of perjury under the laws of the State of California that the foregoing is true and correct <br />Executed on 01/18/07 By <br />Executed on <br />Date <br />Executed on <br />Date <br />Executed on <br />Date <br />ay <br />By <br />Signature of Controlling Officeholder, Candidate, State Measure Proponent <br />FPPC Form 460 (Januaryl05) <br />FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) <br />State of Callfornla <br />By <br />Signature of Controlling Officeholder, Candidate, State Measure Proponent <br />