Laserfiche WebLink
COVER PAGE + <br /> Recipient Committee Date Stamp • - . <br /> Campaign Statement ' � � � � <br /> Cover Page Statement covers eriod Date of Election if a licable � 'i Page 1 of 13 <br /> P PP �� r G� <br /> from 09/20/2015 �� � ��t� ForOfficialUseOnly <br /> 11/03/2015 <br /> through 10/17/2015 (MOnth, Day, Y2ar) <br /> 1. Type of Recipient Committee 2. Type of Statement <br /> ' Officeholder,Candidate Controlled Committee � Primarily Formed Ballot Measure � Pre-election Statement � Quarterly Statement <br /> � State Candidate Election Committee Comminee � Semi-Annual Statement � Special Odd-Year Statement <br /> Q Recall � Controlled � Termination Statement � Supplemental Pre-election <br /> � General Purpose Committee � sponsored ❑ Amendment Statement-Attach Form 495 <br /> � Sponsored Primarily Formed Candidate/ <br /> � Small Contributor Committee � Officeholder Committee <br /> � Political Party/Central Committee <br /> I.D.Number 1377423 <br /> 3. Committee Information Treasurer(s) <br /> COMMITTTEE NAME NAME OF TREASURER <br /> Rosanne Foust for City Council 2015 Russell Miller <br /> STREET ADDRESS <br /> <br /> STREET ADDRESS(NO PO BOX) CITY STATE ZIP CODE AREA CODE/PHONE <br /> Burlingame CA 94010 <br /> CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY <br /> Redwood City CA 99062 Kirk Alan Pessner <br /> MAILING ADDRESS(IF DIFFERENT) STREET ADDRESS <br /> <br /> CIIY STATE ZIP CODE CITY STATE ZIP CODE AREA CODE/PHONE <br /> Burlingame CA 94010 <br /> OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/E-MAIL ADDRESS <br /> ( / <br /> 4. Verification <br /> I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge th formation contained herein is true and <br /> complete. I certify under penalty of perjury under the laws of the State of C o ia that the fore i is true a corre�c <br /> Executed on lo/ Z�/15 By <br /> SIGNA URE OF SURER O�A'S ISTANT TREASURER <br /> Executed on l0/ �l /15 By <br /> SIGNATURE OF CONT OLLWG OFFICEHOLDER,C NDI AT ; i MEASURE PROPONENT OR RESPONSIBLE OFFICER OF SPONSOR <br /> Executed on By <br /> SIGNATURE OF CONTROLLING OFFICEHOL�ER,CANDIDATE.STATE MEASURE PROPONENT <br /> Executed on By <br /> SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE STATE MEASURE?ROPONE�I�bC Form 460-January/O5 <br /> State ot California/St <br />