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� _ _ _ <br /> / <br /> � <br /> Staterra.ent of Organization ' � � STATEMENT OF ORGANIZATION <br /> Type or print in Ink Date Stamp � � <br /> Recipient Committee � �� �,I � � `� � ������ ��� F'�� •' . � <br /> � , . <br /> Statement Type �Initial ❑ Amendment ❑ Termination—See Part 5 �n e office o!th�5�cretary of Stat For OTNdeI Use Only <br /> Not yet qualified � or <br /> List I.D.number: List I.D.number: of the St7te of C2lifomi8 <br /> # # JAN 0� ��a5 <br /> —�—� �—� �� <br /> Date qualified as committee Date qualified as committee Date ot Termination <br /> (If eppllcable) <br /> 1. Committee Information 2. Treasurer and Other Principal Officers <br /> NAME OF COMMITTEE NAME OF TREASURER <br /> Committee to Elect Janet Borgens Redwood City Council 2015 Holiis Matheny <br /> STREET ADDRESS <br /> <br /> STREETADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE <br /> Union City CA 94587 ( <br /> CITY STATE ZIP CODE AREA CODEJPHONE NAME OF ASSISTANT TREA5URER,IF ANY <br /> Redwood City CA 94063 ( <br /> STREET ADDRESS <br /> MAILING ADDRESS(IF DIFFERENT) <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> OPTIONAL: FAX/E-MAIL ADDRESS <br /> NAMEAND POSITION OF OTHER PRINCIPALOFFICER(S),IFAPPLICABLE <br /> COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT <br /> THAN COUNTY OF DOMICILE MA�LING ADDRESS <br /> San Mateo <br /> CITY STATE ZIP CODE AREA CODEIPHONE <br /> Attach additional information on appropriately labeled continuation sheets. <br /> 3. Verification <br /> I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contai d herein is true and complete. I certify under penalty of <br /> perjury under the laws of the State of California that the foregoing is true and e �___-� <br /> Executed on January 1sr, 2015 gy f <br /> DA7E > SIGNA OFTR RORASSISTANTTREASURER <br /> Executed on January 1 St, 2015 gY <br /> DATE SIGNATURE OF CONTROLLING OFFICEH ER,CANDIDATE,OR STATE MEASURE PROPONENT <br /> Executed on By <br /> DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT <br /> Executed on By <br /> DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT <br /> FPPC Form 410(Januaryl05) <br /> FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) <br />