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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 1/1/09 <br /> through 6/30/09 <br /> �. Type of Recipient Committee: All Committees—Complete Parts 1,2,3,and 4. <br /> � Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure <br /> Q State Candidate Election Committee Committee <br /> Q Recall Q Controlled <br /> (A/so Complete Part 5) Q Sponsored <br /> (Also Comp/ete Part 6) <br /> ❑ General Purpose Committee <br /> Q Sponsored � Primarily Formed Candidate/ <br /> Q Small Contributor Committee Officeholder Committee <br /> Q Political Party/Central Committee (A/soComp/etePart7) <br /> 3. Committee Information �•D. NUMBER <br /> 1255762 <br /> COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) <br /> Committee to Elect lan Bain <br /> STREET ADDRESS(NO P.O. BOX) <br /> <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> Redwood City CA 94061 <br /> MAILING ADDRESS (IF DIFFERENT) N0.AND STREET OR P.O. BOX <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> OPTIONAL: FAX/E-MAIL ADDRESS <br /> Date of election if appli <br /> (Month, Day,Year) <br /> Date Stamp <br /> ,_ -� ,: <br /> �� �� - ' �Page <br /> � ��`�'� � �:� ��J`� ' # <br /> �_ k <br /> COVER PAGE <br /> � of 3 <br /> For Official Use Only <br /> 11/6/07 � "' ::;;��, <br /> - s..,.. ., .. ' ,_s �...._� _.�.�. <br /> 2. Type of Statement: <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 /> Treasurer(s) <br /> NAME OF TREASURER <br /> Lorianna Kastrop <br /> MAILING ADDRESS <br /> <br /> CITY STATE ZIP CODE <br /> <br /> NAME OF ASSISTANT TREASURER, IF ANY <br /> MAILING ADDRESS <br /> CITY STATE ZIP CODE AREA CODE/PHONE <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 knowled e 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 corre . <br /> Executed on �, � ��� BY � <br /> �e ignature of TreasurerorAssistant Treasurer <br /> Executed on � � O � By . <br /> p� Signature of Controlling Officeholder,Candidate,State Measure Proponent or Responsible Officer of Sponsor <br /> Executed on <br /> Date <br /> Executed on <br /> Date <br /> By <br /> Signature of Controlling Officeholder,Candidate,State Measure Proponent <br /> By <br /> Signature of Controlling Officeholder,Candidate,State Measure Proponent <br /> FPPC Form 460(January/05) <br /> FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) <br /> State of California <br />