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Reci ient Committee COVERPAGE <br /> p Type or print in ink. Date Stamp � <br /> Campaign Statement ' �'� � • i <br /> Cover Page <br /> (Government Code Sections 84200-84216.5) page—L.— of_1 `! <br /> Statement covers period Date of election if applicable: <br /> 9/20/15 (Month, Day,Year) i �,r F� . For Offidal Use Only <br /> from ,�. � ��i�l�`r <br /> SEE INSTRUCTIONS ON REVERSE through 10/17/15 11/3/15 <br /> 1. Type of Recipient Committee: All Committees-Compiete Parts 1,z,s,and 4. 2. Type of Statement: <br /> � Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure � Preelection Statement ❑ Quarterly Statement <br /> Q State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd-Year Report <br /> Q Recall Q Controlled <br /> (AlsoCompletePartS) ❑ TerminationStatement ❑ SupplementalPreelection <br /> Q Sponsored (Also file a Form 410 Termination) Statement-Attach Form 495 <br /> (A/5o Complete Part 6) <br /> ❑ General Purpose Committee ❑ Amendment(Explain below) <br /> Q Sponsored � Primarily Formed Candidate/ <br /> Q Small Contributor Committee Offlceholder Committee <br /> Q Political Party/Central Committee (AlsoCompletePart7) <br /> 3. Committee Information �.D. NUMBER Treasurer(s) <br /> COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER <br /> lan Bain for City Council 2015 Lorianna Kastrop <br /> MA�LING ADDRESS <br /> 28 Meadow Lane <br /> STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE <br /> 1772 Anamor Street Redwood City CA 94061 650-368-7143 <br /> CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANV <br /> Redwood City CA 94061 650-361-8528 <br /> MAIIING 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 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 Iaws of the State of California that the foregoing is true and correct. ,� <br /> �.-i <br /> 10/22/15 <----- <br /> Executed on By <br /> Dete ! '.i Sgn ureofTrea orAsslstantTreasurer <br /> 10/22/15 � <br /> Executed on By -° �"s ' <br /> Date Signa ure of Conhoiling Otfroehdder,Candi ,State Measure roponent orResponsibleOfficerof Sponsor <br /> Executed on By <br /> Date Signature of ControAing Officeholder,Candidate.Sfale Measure Proponent <br /> Executed on By <br /> Date SgnatureofControNingOfficeFwlder,Candidate,SfateMeasurePropa�ent FPPC Form 460(January/05j <br /> FPPC Toll-Free Helpline:866/ASK-FPPC(866/2753772) <br /> State of Caiifomia <br />