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Officeholder and Candidate Dale unn , <br /> Campaign Statement - RECEIVED • - <br /> Short Form Date of election if applicable: ❑ Amendment (Explain Beem) For Official Use Only <br /> (Month, Day, Year) <br /> JR1t� 3 �; ZOZO <br /> ity of Redwood City <br /> 1. Statement Covers Calendar Year 20 g . <br /> 2. Officeholder or Candidate Information 3. Office Sought or Held <br /> NAME OF OFFICEHOLDER OR CANDID TE OFFICE SOUGHT OR HELD <br /> STREETADDRESS <br /> 1�-�'e-d L^jUWI ( FAPPLICABLE) <br /> CITY STATE ZIPCODE <br /> 12 ''E Ct� { OLD <br /> AREA CODEMAYTIM E PHONE NUMBER OPTIONAL: FAX / E-MAILADDRESS <br /> LcS o <br /> 4. Committee Information <br /> List all committees of which you have knowledge that are primarily formed to receive contributions or to make expenditures on behalf of your candidacy. <br /> COMMITTEE NAME AND I.D. NUMBER COMMITTEE ADDRESS NAME OF TREASURER <br /> S. Verification <br /> I declare under penalty of perjury that to the best of my knowledge I anticipate that I will receive less than S2 ,000 and that I will spend less than 52,000 during the calendar year and that I have <br /> used all reasonable diligence in preparing this statement. I certily under penalty of perjury under the laws of the Statee ofof\yCalifornia that the foregoing is true and correct. <br /> Executed on By `-"'4 <br /> DATE G NATUREOFOFFICEHOLDEHOBCAHD ATE <br /> C Ferns Print Form <br /> FPPC Form 4701470 Supplement (Jan/2016) <br /> FPPC Advice: advice @fppc.ca.gov (8661276.4772) <br /> www.fppc.ca.gov <br />