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Recipient Committee <br /> Campaign Statement <br /> Cover Page <br /> (Goverr�ment Code Sections 84200-84216.5) <br /> SEE INSTRUCTIONS ON REVERSE <br /> Type or print in ink. <br /> Statement covers period <br /> from 7/1/09 <br /> through 12/31/09 <br /> �. Type of Recipient Committee: All Committees—Complete ParLs 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) � Sponsored <br /> (Also Complete Part 6) <br /> ❑ General Purpose Committee <br /> Q Sponsored <br /> Q Small Contributor Committee <br /> Q Political Party/Central Committee <br /> � Primarily Formed Candidate/ <br /> Officeholder Committee <br /> (Also Comp/ete Part 7) <br /> 3. Committee Information 1.D. "uMBER <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 appl <br /> (Month, Day,Year) <br /> 11/6/07 <br /> Date Stamp <br /> � � � � d � <br /> � FEB 0 5 2010 <br /> 2. Type of Statement: <br /> ❑ Preelection Statement <br /> � Semi-annual Statement <br /> ❑ Termination Statement <br /> (Also file a Form 410 Termination) <br /> ❑ Amendment(Explain below) <br /> ClTY <br /> COVER PAGE <br /> Page�_ of � <br /> For Official Use Only <br /> ❑ Quarterly Statement <br /> ❑ Special Odd-Year Report <br /> ❑ Supplemental Preelection <br /> Statement-Attach Form 495 <br /> Treasurer(s) <br /> NAME OF TREASURER <br /> Lorianna Kastrop <br /> MAILING ADDRESS <br /> <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> Redwood City CA 94063 <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 knowle he 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 correct. <br /> � <br /> Executed on � s�� BY <br /> Date �/j , Si ture of Treasurer or Assistant Treasurer <br /> Executed on � / � ���f�� <br /> Da <br /> Executed on <br /> Date <br /> Executed on <br /> Date <br /> w <br /> gy ^�-,°`l.-:+"' <br /> By <br /> Signature of Controlling Officeholder,Candidate,State Measure Proponent <br /> By <br /> Signature ofControllingOfficeholder,Candidate,State Measure Proponent FPPC Form 460(January/OS) <br /> FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) <br /> State of California <br />