HomeMy WebLinkAbout2021 Statement of Organization Date Stamp _
Recipient Committee IEIV n •
Statement Type ❑initial ® Amendment ❑ Termination—See Part 5 1 foI E NI[at Cse Orly
Q Not yot qualified FEB 0 12021
or
O Date qualification threshold met Date qualification threshold met Date of termination CITY CLERKS DEpT•
—�—J 11 25/ 2 t /
Committee1. LD. Number �12. Treasurer and Other Principal Officers
FAePr4o(1r1
HAVE OF COMY11EE NAME OF TREASURER
Committee to Elect Matt Rahn 2022 Adam Rideau
STA((T ADORESS(NO PO.BOX)
2516 Deep Eddy Trail
STREET ADDRESS(NO PO BON) CITY STATE ZIP CODE AREA COMPHONE
32787 Cleveland St Keller TX 76248 817.807-8959
CITY STATE lip CCDE ARE,(ODE/PH0NL NAME OF ASSISTANT TREASURER,IF ANY
Temecula CA 92592 619-846-1916
WILL MAILING ADDRESS(;F 041(RENT) STREET AODRESS INO PO.BOX)
E MA,i ADDRESS(R(OLARED)/FAX(OPTIONAL) CITY STATE 1111CODE AREA CODE/PHONE
mattrahn@me.com
COUNTY OF DOMICILE SDICTION W-(RE CCNIWITTEE IS ACTIVE NAME Of PRINCIPAL OFFICER($)
Riverside City of Temecula
STREET ADDRESS(NO P.O.80R)
CITY STATE 241 CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
3. Verification
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 perjury under the laws of the State of Calijprnia that a foregoi is a and correct.
Executed on 1/25/21 By
DATE SIGNA E TTREASURER
Executed on 1/25/21 By --
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT -
Executed on By
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:advicetmfooc.ca.Etov(866/275-3772)
www-fooc.ca.gov
Statement of Organization CALIFORNIA ,
Recipient Committee • -
IN57RUCTIONS ON REVERSE
Page 2
COMMIT TEE NAFAE C t:J1.'flER
Committee to Elect Matt Rahn 2022
• All committees must list the financial institution where the campaign bank account is located.
F-,%Vt Or F'NAM,OAI INSTITUTION AREA CCCE/FaONE BAN K ACCOUNT NUMBER
Bank of America 951-676-4114 325026403913
ncUPE S4 CITY STATE ZIP CODE
27489 Ynez Rd Temecula CA 92591
4.Type of Committee Complete the applicable sections.
• 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 DISTRICI NUMBER IF APPLICABLE) ELECTION CHECK ONE
Nonpartisan Partisan (list poMical party below)
Nonpartisan P&I'san (list political party below)
FormedPrimarily Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIOATE(S)NAME OR MEASURE(S)FULL TITLE(INCLUDE BALLOT N0,OR LETTER) CANDIDATF(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 APPLICABLEI CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410(August/2016)
FPPC Advice:advicePfaac.ca.aov(866/275-3772)
www.fppc.Ca.eov
Statement of Organization CALIFORNIA '
Recipient Committee • -
INSTRUCTIONS ON REVERSE
Page 3
COMMITTEE NAME I.O.NUMOER /
C � 6 �� 1
General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
Sponsored Committee List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO.AND STREET CITY STATE ZIP CODE AREA CODE/PHONE
Small Contributor Committee
❑ /�
Date qualified
5. • Riiiquieem-ents By si.gnIng the verification,the treasu I rer I,assistant tr I easurer and/or candidate I,officehol der,or ponent certify that all of the following conditions have been met:
• This committee has ceased to receive contributions and make expenditures;
• This committee does not anticipate receiving contributions or making expenditures in the future;
• This committee has eliminated or has no intention or ability to discharge all debts,loans received,and other obligations;
• This committee has no surplus funds;and
• This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions.
— There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to
Government Code Section 89519.
— Leftover funds of ballot measure committees maybe used for political, legislative or governmental purposes under Government Code Sections 89511-
89518, and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5.
FPPC Form 410(August/2018)
FPPC Advice:adyicelafDyc.ca.Koy(866/275-3772)
vrww.fapc.ca.aov