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Statement of Organization STATEMENT OF ORGANIZATION <br /> Recipient Committee <br /> Type or print In ink Date Stamp CALIFORNIA <br /> _ FORM 410 <br /> Statement Type rib— `'�" '� '' � i,YP ❑Initial ® Amendment ❑ Termination—See Part 5 ,_ L L� I 1`11 For Official Use Only <br /> List I.D.number: List I.D.number: !,; i I <br /> Not yet qualified 0 or Ltd <br /> # 1313963 # 111111_ JUL 0 9 2009 <br /> ._1� 12 i 03 1 08 _J_ cir�'o=RE C�CLERK <br /> CITY <br /> Date qualified as committee Date qualified as committee Date of Termination <br /> (If applicable) <br /> 1. Committee Information 2. Treasurer and Other Principal Officers <br /> 40 NAME OF COMMITTEE NAME OF TREASURER <br /> ,�' John Seybert for Redwood City Council-2009 Richard Claire <br /> , STREET ADDRESS(NO P.O.BOX) <br /> <br /> STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE <br /> Redwood City CA 94062 <br /> CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY <br /> Redwood City CA 94062 - <br /> MAILING ADDRESS(IF DIFFERENT) <br /> STREET ADDRESS(NO P.O.BOX) <br /> Redwood City, CA 94062 CITY STATE ZIP CODE AREA CODE/PHONE <br /> OPTIONAL: FAX/E-MAIL ADDRESS <br /> NAME OF PRINCIPAL OFFICER(S) <br /> COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT <br /> THAN COUNTY OF DOMICILE STREET ADDRESS(NO P.O.BOX) <br /> San Mateo <br /> CITY STATE ZIP CODE AREA CODE/PHONE <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 contained 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 correct. <br /> c <br /> J " <br /> Executed on 7 9490 By <br /> SIGNAT•' OF REA URE' - SSISTANT TREASURER <br /> Executed on 7 q • By di A <br /> •A E _ *-E OF CONTROLU' 1FF EH'' *ER,C NDIDATE,OR STATE MEASURE PROPONENT <br /> Executed on By <br /> DATE SIGNATURE OF CONTROLUNG OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT <br /> Executed on By <br /> DATE SIGNATURE OF CONTROLUNG OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT <br /> FPPC Form 410 (June/09) <br /> FPPC Toll-Free Helpline: 866/ASK-FPPC (866/2754772) <br />