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AMENDMENT TO CAMPAIGN DISCLOSURE STATEMENT ~ I-~ ca E~ <br /> ~~ Th S form must be used to amend statements filed pursuant to Government i1",~ [~ <br /> m"" ~ Code Se~ions 84200-8~216.5. and must be filed with all filing officers who i~ <br /> amend a Statement of Organization (Form 410). To amend a Statement of !~-- <br />~ Organization, use. the Form 410. ~~00b 6hY <br /> FORM 405 - (Type or Print in Ink) .- t CITY CLERI< <br /> 'Jg~0 -- · FOR OFFICIAL US[ ONLY <br /> A <br /> <br /> i. The information required in Section I must correspond to the information provided <br /> on the campaign statement. <br /> <br /> NAME OF FILER: (See importantmtotmatlononceverse ) I.D. NO. (IF APPLICABLE); <br /> 880343 <br /> 'Judy Buchan <br /> MAILING ADDRESS OF FILER: NO AND STREET CITY - STATE ZiP CODE AREA CODE/PHONE NUMBER <br /> <br /> Redwood City CA 94063' ( <br /> <br /> NAME OF TREASURER IF RECIPIENT COMMil'I'EE: <br /> Dorothy Buchan <br /> PERMANENT ADDRESS OF TREASURER (IF APPLICABLE); NO. AND STREET CITY STATE ZIP CODE AR£A CODE/PHONE NUMBER <br /> Redwood City CA 94063 ( <br /> <br /> II. The following information amends campaign disclosure statement, Form No. 490 ' . Executed on <br /> <br /> III. The amenclecl reformation affects items on the: <br /> ~ Summary Page <br /> E] cover Page E] Allocation Page <br /> 1'-] Schedule(s) E] Pa~(s) <br /> <br /> IV. De~:ribe the change~ below. Include in de,ail all information, you wish to become a part of your official campaign <br /> statement. Also at~ach a ~.o~er page, summary page or appropriate schedule if needed for clarification. <br /> <br /> Math' corrections ' <br /> <br /> includendd~tlon~linformatlononaoproor,a~etyiabeleclconnnu:~tlonshee~ (Number of Dag~a~ac~ed__ ) <br /> <br /> VERIFI~ON <br /> I HAVE 'USED ALL REASONABLE DILIGENCE IN PREPARING THIS STATEMENT I HAVE REVIEWED THE STATEMENT AND TO THE BEST OF MY <br /> KNOWLEDGE THE INFORMATION CONTAINED HEREIN AND IN THE A~ACHED SCHEDULES IS TRUE AND COMPLETE. <br /> I CERTIFY UN~R PEN&LTY OF PERJUR~UNDER TH~ ~ OF THE STATE~OF ~LIFQRNI~THAT THE FOREGOING IS TRUE AND CORRECT <br /> <br /> A ~N~AT[, OFF~[HOLDER OR STAT[ ~EASUR[ ~O~N[NT WHO CONSOL5 A CO~[[ ~5T A~O V[~FYTHIS <br /> A~END~ENTTO THE ~A~ 5~ATE~[NT <br /> I HAVE USED ALL REASONABLE DILIGENCE. AND TO THE BEST OF MY ~WLEDGE. THE TREASURER HA~ USED ALL REASONABLE <br /> DILIGE~E IN PREPARING THIS STATEMENT I reAVE REVIEWED THE STATEMENT AND TO THE BEST OF MY KNOWLEDGE THE <br /> IN~R~T~N CONTAINED HEREIN AND IN THE A~ACHED SCHEDULES IS TRUE AND COMPLETE. <br /> C <br /> <br /> ~x~CUT~ O~ IF:"__ .~ .~ <br /> D <br /> <br /> E EXECUTED ON AT ~Y <br /> F EXECUTED ON ~T BY <br /> <br /> -1 <br /> <br /> <br />