HomeMy WebLinkAbout2020 Date Stamp
Statement of Organization .
Recipient Committee (,
Statement Type nitial ❑ Amendment ❑ Termination—See Partr5t e LIVEDr• �1 For Official Use Only
o +ce of the Secreta of tat
Not yet qualified of the Statg 3; 30
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O Date qualification threshold met Date qualification threshold met Date of termination JUL 3 RECEIVIED
Committee1. I.D. Number • Officers
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NAME OF COMMITTEE �. NAME TpRE111RER `
po _ CITY CLERKS DEI Dr.
STREET ADDRESS(NO P.O.BOX)
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STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CO / E
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT THE URER,IF AN
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FULL MAILING ADDRESS(IF DIFFERENT) STREET ADDRESS(NO P.O.BOX)
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E-MAIL ADDRESS(REQUIRED)/FAX(OPTIONAL)JC ,,�1�(iC-� 7 u,L:. - 7"fit'(L) 77� STY STATE ZIP CODE `A' QE/Pl{O�NE 1
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COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S)
STREET ADDRESS(NO P.O.BOX)
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Attach additional information on appropriately labeled contini •on she ts. CITY STATE ZIP CODE AREA CODE/PHONE
3. Verification
I have used all reasonable diligence in preparing this statem nt and to the best of my ow dg information contained herein is true and complete. 1 certify under
penalty of perjury u er the I ws of the State of California at the fore Ming is true nd co re
Executed on _(" By
DA ASURER OR ASSISTANT'MEASURER
7-/Executed on 7 / `C By
DATE SIG F CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
Executed on By TU O
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
FPPC Form 410(August/2018)
FPPC Advice:advice-@fppc.i a,eov(866/275-3772)
www.fppi;tcA.gov
Statement of Organization CALIFORNIAi
Recipient Committee • -
INSTRUCTIONS ON REVERSE
Page 2
COM(pM,'T�\TEE NAME
I.D.NUMBER
'j
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
ADDRESS CITY STATE ZIP CODE
4.Type of Committee Complete the applicable sections,
Controlled Committee
• List the name of each controlling officeholder,candidate,or state measure proponent. If candidate or officeholder controlled,
also list the elective office sought or held,and district number, if any,and the year of the election.
• List the political party with which each officeholder or candidate is affiliated or check"nonpartisan." Stating"No party preference" is acceptable
• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
Nonpartisan Partisan (list political party below)
c�cAC- 4 nI C
Nonpartisan Partisan (list politic I party below)
: Primarily1-114
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S)NAME OR MEASURE(S)FULL TITLE(INCLUDE BALLOT NO.OR LETTER) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION
IF A RECALL,STATE"RECALL"IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410(August/2018)
FPPC Advice:advice@fppc.ca.eov(866/275-3772)
www.fPPc_ca.gov