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Recipient Committee <br /> Campaign Statement <br /> Cover Page <br /> (Government Code Sections 84200-84216.5) <br /> Type or print in ink. <br /> Statement covers period <br /> from 1/1/2010 <br /> SEE INSTRUCTIONS ON REVERSE I through 6/30/2010 <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 /> (Also Complete Part 5) 0 Sponsored <br /> (Also Comnlete Part 61 <br /> ❑ General Purpose Committee <br /> � Sponsored <br /> Q Small Contributor Committee <br /> Q Political Party/Central Committee <br /> � Primarily Formed Candidate/ <br /> Officeholder Committee <br /> (Also Complete Part 7) <br /> 3. Committee Information (•D. NUMBER <br /> 1253171 <br /> COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) <br /> ROSANNE FOUST FOR CITY COUNCIL <br /> STREET ADDRESS (NO P.O.BOX) <br /> <br /> CITY STATE ZIP CODE AREA <br /> <br /> MAILING ADDRESS (IF DIFFERENT) NO.AND STREET OR P.O. BOX <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> OPTIONAL: FAX/E-MAIL ADDRESS <br /> COVER PAGE <br /> Date Stamp <br /> � � � <br /> Date of election if applicabl JU� 2 1 2010 9e � of 3 <br /> (Month, Day,Year) For Official Use Only <br /> CITY CIN CLERKD CITY <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 OFTREASURER <br /> RICHARD S. CLAIRE <br /> MAILING ADDRESS <br /> SAM E <br /> CITY STATE ZIP CODE AREA CODE/PHONE <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 knowledge th ' formation contained herein and in the attached schedules is true and complete. I certify <br /> under penalty of perjury unde he I s of the State of Califomia that the foregoing is true and cor . / <br /> � � . <br /> Executed on gy ft <br /> a� Signature of T easurer orAssistant Treasurer <br /> �,. <br /> Executed on g ' '�` <br /> ate y Signature of Controlling Officeholder,Candidate,State Measure Proponent or Responsible Officer of Sponsor <br /> Executed on gy <br /> Date Signature of Controlling Officeholder,Candidate,State Measure Proponent <br /> Executed on gy <br /> Date Signature ofControlling Officeholder,Candidate,State Measure Proponent FPPC Form 460(January105) <br /> FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) <br /> State of California <br />