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� COVERPAGE <br /> Recipient Committee T <br /> Campaign Statement Ype or print in ink. � <br /> �$�� �� ' • 1 <br /> Cover Page ���:�;°�� �� � <br /> •- <br /> (Government Code Sections 84200-84216.5) <br /> Statement covers period Date of election if appllcable: �R� � s� ��� Pa af 3 <br /> from 7/1/14 <br /> (Month, Day,Year) '��'�� � <br /> For icial Use Only <br /> �E I�'�J� J'e"i' ._ � <br /> SEE INSTRUCTIONS ON REVERSE through 12/31/14 �� � <br /> 1. 'rype of Recipient Commlttee: Ail Committees—Compiete Parts 1,s,s,and 4. 2. Type of Statement: <br /> � Officeholder,Candidate ConVolied Committee ❑ Balbt Measure Committee ❑ Preelection Statement � Quarterly Statement <br /> Q State Candidate Election Committee Q Primarily Formed [� Semi-annual Statement � Special Odd-Year Report <br /> Q Recail Q Controiled <br /> (AlsoCompfetePartS) ❑ TertninationStatement ❑ SupplementaiPreelection <br /> � Sponsored � Amendment(Explain below) Statement-Attach Form 495 <br /> ❑ GeneralPurposeCommittee (AlsoCompletePart6) <br /> Q Sponsored � Primarily Formed Candidate/ <br /> Q Small Contributor Committee Officeholder Committee <br /> Q PoliticalParty/CentralCommittee (A�soComp/etePart7) <br /> 3. Committee Information I.D. NUMBER Treasurer(s) <br /> 1313963 <br /> COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER <br /> JOHN SEYBERT FOR CITY COUNCIL 2013 RICHARD S. CLAIRE <br /> MAII.ING ADDRESS <br /> SAME <br /> STREET ADDRESS(NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE <br /> <br /> CITY STATE ZIP CODE <br /> <br /> MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O. BOX MAILING ADDRESS <br /> CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE <br /> OPTIONAL: FAX/E-MAIL ADDRESS 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 o y nowle e ttag information contained herein and in the attached schedules is true and complete. t <br /> certify under penalty of perjury under the laws of the State of Califomia that the foregoing ' " e nd c e`ct. � <br /> 1/10/14 '� ` <br /> Executed on By <br /> Data eof urarot reasurer <br /> Executed on By <br /> Date Si{�eture of Cont ling Office ,Candd�e, ts Measure Proponent or Respons3�ie Officar of Sponsor <br /> Executed on By <br /> DaOa Si�ature of ControUing Officehdder,Candklate,State AAeasire ProponeM <br /> Executed on BY FPPC Form 460 June/01 <br /> Date Signature of Controlling Officehdder,Candidate,S[ate Meastre Proponent � � <br /> FPPC Toll-Free Helpiine:8661ASK-FPPC <br /> State ot Calffornla <br />