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Recipient Commit�e `� ��s �~ CO�R P`� <br /> Campaign Statement TyPe or print tn ink. �,,��� _��g - , . , <br /> Cover Page �` � �_;� � -i :-� � • 1 <br /> (Govemment Code Sections 84200-84216.5) S E P 2 3 2 015 <br /> Statement covers period Date of election if applicab : g <br /> July 1,2015 (Month, Day,Year) Fage of <br /> from �� „z:t. y;:� ' r� For iaal Use Only <br /> SEE INSTRUCTIONS ON REVERSE chrougn September 19, 2015 2015 Election � � 6i}�YC y�, _,v _. .�.-� <br /> 1. Type of Reclpient Committee: Aq CommiCass—Compleb Parts 1,x,a,ana 4. Z. Type of Statement: <br /> � Officehoider,Candidate Controiled Committee ❑ Ballot Measu�e Committee � Preelection Statement ❑ QuarteMy Statement <br /> Q State Candidate Election Committee Q Primarity Formed ❑ Semi-annual Statement ❑ Special Odd-Year Report <br /> Q Recali Q Controlled Terminafion Statement <br /> (AI�CanpletePaRS) Q Sponsored � ❑ SuppiementalPreelection <br /> (AlsoCompbMPart6) ❑ Amendment(Explain bebw) Statement-Attach Fonn 495 <br /> ❑ General Purpose Committee <br /> Q Sponsored ❑ Primarily Formed Candidate/ <br /> Q Small Contributor Committee Officeholder Committee <br /> Q PoliticalParty/CerrtralCommittee (AlsoCompbtePart7) <br /> 3. Committee Information �•D. NUMBER Treasurer(s) <br /> 1374422 <br /> COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER <br /> Committee to Elect Janet Borgens for Redwood City Council 2015 Hotiis Matheny <br /> MAILING ADDRESS <br /> <br /> STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE <br /> Union City Ca 94587 ( <br /> CITY STATE 21P CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY <br /> Redwood City Ca 94063 ( <br /> MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.90X MAILING ADDRESS <br /> CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODElPHONE <br /> OPTIONAL: FAX 1 E-MAIL AODRESS OPTIONAL: FAX/E-MA�L ADDRESS <br /> 4. Verification <br /> I have used aN reasonable diligence in preparing a�d reviewing this statement and ta the best of my knowledge the inf afion contained herein and in the attached schedules is true and complete. I <br /> cert'dy under penalty of pery'ury under the laws of the State of Califomia that the foregoin is true and corred. <br /> Executed on By <br /> 9 / J reof a �Treasu�er <br /> 6 �� L <br /> ����On Date By o}CGMfO�inpOlBC9tWWM �9StateNbeswa onBMOrReSpOnabkkOfACBrotSpDnsor <br /> Executed on Dab By SipnahraofConhidGrigOfficeMidar,Candida�,StateAAeaawePropenent <br /> ecut on <br /> PPPC Form 160 Jum/01 <br /> oaoe � sipnaa,re orcomrdfirg orficeholder.car�dere,stete Meaeua Pinponent l l <br /> FPPC Toll-Free Helpiita:888/ASK-FPPC <br /> State of Califomia <br />