Laserfiche WebLink
<br /> i <br /> 1 <br /> RecipientCommittee T COVERPAGE ! <br /> Campaign Statement YPe or print in ink. oate Stamp <br /> ~ <br /> Cover Page ~ , <br /> (Govemment Code Sections ~ <br /> Statement covers period Date of electfon if applicable: Page of s i <br /> Jan. (Month, Day, Year) ' For Official Use Only j <br /> from <br /> { <br /> SEE INSTRUCTIONS ON REVERSE tnrou9n June November S, ~ <br /> ~ <br /> Type of Recipient Committee: All CommfBees - Complete Parts z, s, er,a a. Type of Statement: ~ <br /> ~ Officeholder, Candidate ConVolled Committee n Primariiy Formed Ballot Measure ? Preetection Statement n Quarterly Statement ? <br /> Q State Candidate Election Committee Committee Semi-annual Statement • Y <br /> i <br /> Recall Controlled ~ ? Special Odd-Year Report <br /> ~ 0 ~ Termination Statement ~ Supplemental Preelection <br /> (AlsoCompletePort 0 Sponsored (Also file a Form Termination) Statement - Attach Fortn ; <br /> (asoc-petePart s) <br /> ? General Purpose Committee ? Amendment (ExPlain below) <br /> Q Sponsored E] Primarily Formed Candidate! <br /> Q Small Contributor Committee Officeholder Committee <br /> Q Political Party/Central Committee (Also Complete Part <br /> Committee Information 1 I.D. NUMBER Treasurer(s) <br /> COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER <br /> Committee to Elect Hilary Paulson Peggy <br /> ADDRESS <br /> Alden Street <br /> STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE <br /> Country Club Drive Redwood City CA <br /> CITY STATE ZIP CODE AREA CODElPHONE NAME OF ASSISTANT TREASURER, IF ANY <br /> Redwood City CA Hilary Paulson ' <br /> MAILING ADORESS (IF DIFFERENT) N0. AND STREET OR P.O. BOX MAILING ADDRfSS <br /> Country Club Drive <br /> AREA CODE/PHONE CITY STATE ZIP CODE AREA CODElPHONE <br /> -Red+aeeEl-6ity eA-94?6± s' CA <br /> OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS <br /> Verification <br /> I have used atl reasonable diligence in preparing and reviewing this statement and to the best of my dge the info tion contained herein and in the attached schedules is true and complete. <br /> under penalty of perjury under ihe laws of the State of Caiifornia that the foregoing is true and cor t. <br /> Executedon Lx- By <br /> D rea or 'stantTieasurer . <br /> Executed on By , <br /> Data S' oF irg Officeholder, Candidate, State Measure ProponeM or Responsible Officerof Sponsor <br /> Executed on By <br /> Date Signature of Contropirg Officehokler, Cardidate, State Measure Proponent Executed on By , <br /> DaTe SigmWie of Controlling OFficeholder, Candidate, State Measure Proponent . <br /> FPPC Fortn (January/05) <br /> FPPC Toll-Free Helpline: 866/ASK-FPPC <br /> StaM of Callfomia