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Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee / Type or print in ink Date Stamp r RE EIVED ACID FIL Statement Type ❑ Initial ❑ Amendment ® Termination — See Part Sin th office of the Secretary of St List I.D. number: List I.D. number: of the State Of California Not yet qualified El or 1 MA :28 # # 1229403 APR 2 2 2011 L�IJ I ft 1t UI Y(J�Ef�J 03 31 2011 D EBRA BOWEy OO,yTY OF RIVERSIDE Date qualified as committee Date qualified as committee Date of Termination eCretar Of State (If applicable) Y 1. Committee Information 2. Treasurer and Other Principal Officers NAME OF COMMITTEE NAME OF TREASURER MAY 12 2011 Committee to Re -elect Ron Roberts Jeanne Roberts STREET ADDRESS (NO P.O. 80X) - �. 41140 Avenida Verde STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE 41140 Avenida V erde Temecula Ca 92591 (951) 676 -2004 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Temecula Ca. 92591 (951) 694 -6440 MAILING ADDRESS (IF DIFFERENT) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX/ E- MAILADDRESS NAME OF PRINCIPAL OFFICER(S) COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE STREETADDRESS (NO P.O. BOX) Riverside County CITY STATE ZIP 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 California that the foregoing is true and correct. Executed on ' By DATE FT SURER OR ASSISTANT TREASURER O Executed on d ot - 2 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 (June /09) FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661275 -3772) Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee CALIFORNIA 1 FORM INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER Committee to Re -elect Ron Roberts 1229403 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 "non- partisan." • 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 NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY © Non - Partisan Ron Roberts City of Temecula City Council 2010 ❑ Non - Partisan • List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION AREACODE /PHONE BANKACCOUNTNUMBER California Bank /Trust (951) 695 -1376 2270091606 ADDRESS CITY STATE ZIP CODE 30580 Rancho California Road Temecula Ca 92591 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 (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 410 (June /09) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Statement of Organization STATEMENT OF ORGANIZATION .� Recipient Committee CALIFOIR .- INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D. NUMBER Committee to Re -elect Ron Roberts 1229403 4.Type of Committee (Continued) • • • 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 .. . List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR . STREETADDRESS NO. AND STREET CITY STATE ZIP CODE ❑ Date qualified 5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and /or candidate, officeholder, or proponent 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 may be 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 (June /09) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Statement of Organization STATEMENT OF ORGANIZATION � Type or print in ink Date Stamp _ Recipient Committee EGEIVED � •- Statement Type ❑ Initial ❑ Amendment ® Termination —See Part 5 APR 1 9 2U11 For OfBotal Use On Not yet qualified El or List I.D. number: List I.D. number: # # 1229403 `TY CLERKS DEPT I J - J_J 03 1 31 1 2011 Q r 1 nw� o � 'fie Date qualified as committee Date qualified as committee Date of Termination s ehsr yr eT (If applicable) 1. Committee Information 2. Treasurer and Other Principal Officers NAME OF COMMITTEE NAME OF TREASURER Committee to Re -elect Ron Roberts Jeanne Roberts STREET ADDRESS (NO P.O. BOX) 41140 Avenida Verde STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE 41140 Aven V erde Temecula Ca 92591 (951) 676 -2004 CITY STATE ZIP CODE AREA CODE /PHONE NAME OF ASSISTANT TREASURER, IF ANY Temecula Ca. 92591 (951) 694 -6440 MAILING ADDRESS (IF DIFFERENT) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX/ E- MAILADDRESS NAME OF PRINCIPAL OFFICER(S) COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE STREETADDRESS (NO P.O. BOX) Riverside County CITY STATE ZIP 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 California that the foregoing is true and correct. Executed on I V - 1 2- 11 By .(JC DATE FT SURER OR ASSISTANT TREASURER G Executed on f d a f 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 (June /09) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee :'CALIFORINIIA a .- INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER Committee to Re -elect Ron Roberts 1229403 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 "non- partisan." • 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 NAME OF CAN MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY ® Non - Partisan Ron Roberts City of Temecula City Council 2010 ❑ Non - Partisan • List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION AREA CODE /PHONE BANK ACCOUNT NUMBER California Bank /Trust (951) 695 -1376 2270091606 ADDRESS CITY STATE ZIP CODE 30580 Rancho California Road Temecula Ca 92591 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 (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 410 (June /09) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee CALIFORNIA FORM INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D. NUMBER Committee to Re -elect Ron Roberts 1229403 4. Type of Committee (Continued) .. . =M to Not formed to support or oppose specific candidates or measures in a single election. Check only one box: F_] CITY Committee ❑ COUNTY Committee ❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY - . List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREETADDRESS NO. AND STREET CITY STATE ZIP CODE ❑ Date qualified 5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and /or candidate, officeholder, or proponent 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 may be 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 (June /09) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) RECEIVED Statement of Organization DEC — 5 2006 STATEMENT OF ORGANIZATION Reci p lent Committee Type or print In Ink CLERKS DEW,, E1VE F�L WOfficiaf in th office of the Secretary of St Statement Type ❑ Initial ® Amendment ❑ Termination — See Part 6 of the State Ot California nly L ist I.D. number: List I.D. number: Not yet qualified 171 or JUL 3 I # 1229403 # Hand Deliver0d, Sacramento Date qualified as committee Date qualified as committee Date of Termination Bruce VcPherson, Secretary of S to (It applicable) 4 1. Committee Information 2. Treasurer and Other Principal Officers NAME OF COMMITTEE NAME OF TREASURER Committee to Re -elect Ron Roberts Jeanne E. Roberts STREET ADDRESS 41140 Avenida Verde STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 41140 Avenida Verde Temecula Ca 92591 (951) 676 -200 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Temecula Ca 92591 (951) 676 -2004 STREET ADDRESS MAILING ADDRESS (IF DIFFERENT) CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX/ E -MAIL ADDRESS Fax - (951) 693 -0956 NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE MAILING ADDRESS Riverside CITY STATE ZIP CODE AREA CODEIPHONE 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 California that the foregoing is true and correct. Executed on 07 -27 -06 By - DATE _ SIGNATURE EASUR O SSISTANTTRFASURER Executed on 07 -27 -06 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 (January/06) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/276 -3772) a a 2 c m ¢ O ~ t ~ c LL ` a • c • O ~ O (" • W • K L N q ~ • N 0 J ~O~{{ 01 pjp N Z Q eep O ~ ~ ® Z ^ 6 O > Z O F q ~ t0 m LL O O N N ~ q 8 A y d Q O o U Q `~ m N W J T C O V O L O m ~U d ~ fi ` rc °' o o OLL ~ E o d a ~K ~w N E m ~ yf ~ o v c wz ~- ~ ~ C ~ OF O m N O q LL U ~. 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O R' 6 E L >. - d U L ~ O p ~ d C q V Q r 3 T S V £m 3 •~ ~ ~ d a • ~ w O • w m ~ U ~ c 3 O ~ O ~ W W ~ d ..m_. 4 ~ p '~' O ~ K ~ ° - m z o z O ma ~ O ~ C w c c E ~ c ~ d m QQ m n ~ ' ` p ~ Z O Z W " m ~ O ~ «~ ,y m r q W ~ , O ~ m v d ~- v k E a w m £ ~ m ++ v ~ a E !~ :~ v im = o ~ v Z F U ° W q W q ~ Q O V U V J ~ I p u N ~a N ~ < N O Fs E Z ~ 0 00 °' v ~ 9 O a = O ~ _ J N ~ (~ O O q c o ~ ~ ~ jZ r yU c h V 'w LLo q Ow i ~ m ~°o ~ m U .-. ~ ~ O t0 m a ~' v E H 'i v O 2 ~ O {F C F ~ V Z ~ l0 5 Y U c m c LL m O ~ q ~ w ~ m o ~ ~ U ° M b ANA r A ;3 cfl `. m o :° ~ 6 ~LL IL ~' d LL mq 0 C n I 1 f 6 6 LL 09 N r C y O {6 p N N . ~ C ~ ~ ~' E N d O w w O V rc ~ Car 0 w O ~ d ~ d ~ $ p W ~;°' ~ kE `~ ~ ~ ~ E ~~ // `l. ? U V d c O U d E O U 0 a a 0 c T 0 d U c m N N C n m E c u ~ ~ ~ f 0 F E y `o ^ a ~ E c U a d m 2 c O n V n ^ 0 O • n~ n '~ E o E oC V C z°°^ m E L m 0 a c 6 c W 3 m v !E v C E m E E 8 S 8 E N W ~ ~~ °w ~ y ~ c v °' L ~ E~ t4 m m ~ f R ~ a~ £_ o E E Q 8 na ga % b a~ cg 0 N U a 11~ 1~ 10 9E~ E c c a C $_ .~ O m 8 Q 0 S 0 m v e W N c m b S a° >. 61 C d 7 Q C r V1 c Id O C ~j o ~ c O d y n L_ O G N N N j C U O N N YUl C ~ C l0 ~'j .y p Q w ~ E N C N W 9 ~ a ~ ~ .~.. :p W OI :~ N C L O a d p y r ~ E v Y G ~ ~ E ~ ~ v d N O N ~ y ~ O d G C y O_ C p U C C d ~ m E S c m ''-y ~ c L° N d y ~ C • ~ d L n Ol ~' o. ° ~- E .0.. U N ~ 'O C 10 ~ N C ~ (0 m a U y N C w t vp r t t x ~ x x pE pEp pEo E E O U V U U Y! y 01 y y ~ ~ ~ ~ ~ w d d' N N V V c U C N N N a a a C W 0 ~I C .~ d N N £0 3 V O v N W a v N L M C w C .~ n E U fp G y O ~W N ~ V ~ N ~ C O 'Fj C %j O y u 'p O d~ ~ E m E d ~ O N ~ b N r ~~ Z~ o °D c+ C 6 LL LLY Vq Q LL o C 6 1 ~°- a n LL Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee Ty or print In Ink Date Stamp • . , Statement Type ❑ Initial Z Amendment ❑ Termination — See Part 6 nC For Official Use Only Not yet qualified ❑ or List I.D. number: List I.D. number: JUL 1 7 2006 # 1229403 # CI TY CLERKS ® iii _ c opy rocs % ✓iA Jrr•„ti Date qualified as committee Date qualified as committee Date of Termination CI..+�� d �•� (If applicable) 1. Committee Information 2. Treasurer and Other Principal Officers NAME OF COMMITTEE NAME OF TREASURER Committee to Re -elect Ron Roberts Jeanne E. Roberts STREET ADDRESS 41140 Avenida Verde STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE 41140 Avenida Verde Temecula Ca 92591 (951) 676 -2004 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Temecula Ca 92591 (951) 676 -2004 STREET ADDRESS MAILING ADDRESS (IF DIFFERENT) CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/ E -MAIL ADDRESS Fax - (951) 693 -0956 NAMEAND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE MAILING ADDRESS Riverside CITY STATE ZIP CODE AREA CODEIPHONE Attach additional information on appropriately labeled continuation sheets. 3. Verification 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 California that the foregoing is true and correct. Executed on 07 -27 -06 By DATE SIGNATURE EASUR O SSISTANTTREASURER Executed on 07 -27 -06 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 (January/06) FPPC Toll -Free Helpllne: 866/ASK -FPPC (866/276 -3772) l+l i P d y C C w a. N d . c ~ ~ ~ ~•~ U ~ O C N W W ~ "'~ O O V ~ ~ ~ 41 C m Z Q Z d E o z a- a ~ ~ E a~ d ~ ~ ~ f/) ~ ? ~ U 0 G 0 n 0 E U m ~C G O V Q n. F~ v c d 6 P a d 9 m E R w `o d m v v c C a w L « O `gyp ~ T c ~ Q .t. cv C4 m U ~ C N w o~- ma m ~ G ~ ~~ w m ~ 'v '~ a 0 z z 0 U w w O rc r w J o~ J = J a 06 ~ W o~ ~~ wz Ur uv OF ~w 0 W U z O N U E H O U a E m E .~ c U c a t 2 w 0 U a a ~ N m O <D 3 .- o 0I m O n ~ N N r F w ~ U ~ ~ ~ rn l0 U d ~ ~ F A l0 G w .~ U L U C 0 N F C l0 Y c m fD A E N w w U ~ a 9rc =0 OV ~Z LL ~ oa ti~ ~~ o z 6n a '~ e^~ ~~ o ,~ ~CC 6 Cd LL u° !C Q 6 c 5 0 x i F d 6 W m N r C O a a+ p .~ i ~ ~• W V G O G ~ W W OV rc ~ c +. o ~ ~°- W C E •°-' `~ $ ~ d x da ~ d ~ ~ E d) ~ ? v U d c 0 U d E O U 0 a H v It O a m T C O m U 0 m m ~ o c m m E c ~ ~ U ~ W m f E ~ `o ^ m a b EE O a m 2 m ~ o ~ v V o ^ 0 L 0 n n '~ E o E a ~j ~ U z°^ c E m 0 b 0 e C a m J w m 'v ~p U F E 8 `o 0 s 8 N E w m m ~ m " ~ 8 c c °' 0 E" 3 m `3 c £ m ~' w ~ a ° £~ a E 5 E o $ no ma a m E U a I~ c la G d ., Q C a C ui a c m N v C n N O C N L W E E n~- m N l0 v C U V d N N a v c m W U O OI C .' R d d N £O 5 N U O v v N d a v L h C C .~ a E u h d N O C 0 m °a of N r O ~ ~ ~ c C 0 C (n O ~U d E m E w w w > ~~ o~. a ~~ o ._. Su €a 6 LL a 1C U Q LL O 0 e _y6 S i ~°- V 6 6 LL RECEIVED d'IfVD FILED Statement of Organization th e office of the Secretary ENT OF ORGANIZATION Recipient Committee ' vPa °� p" "''�"` , . It V ,alifornia • Statement Type ® Initial ❑ Amendment ❑ Termination!, ggg�...T��� Part 6 P �0 For oalow U. Only Not yet quafifled ❑ or Lltat I.D. number: List I.D. number: V v I J I ,,gy�pp Q� �� � ric � 1t i Ef��ES' Secretary of tats • * '— "`''e'.v� r.I:it Ur r ---VCs 09 / 00 _�� _ OF RI IERSIDE Date qualified as o mmktee Data quWMsd as oommitt" Data of Terminatlon IM ww-aw) 1. Committee Information 2. Treasurer and Other Principal Officers • NAME OF COMMITTEE NAME OF TREASURER Jeanne E. Roberts Committee to Re -Elect Ron Roberts '"""N° ADDR 411 Avenida Verde STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE 41140 Avenida Verde Temecula CA 92591 (909) 676 -2004 CITY STATE ZIP CODE AREA CODE /PHONE NAME OF ASSISTANT TREASURER, IF ANY Temecula CA 92591 (909) 676 -2004 MAILING ADDRESS (IF DIFFERENT) MAILING ADDRESS Same CITY STATE APCODE AREACODE/PHONE OPTIONAL: FAX /E-MAILADDRESS FAX 909 693 -0956 e -mail: rrobe cit council.or NAME AND POSmoNOF OTHER PRINCIPAL OFFICER (S),IFAPPUCABLE COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE MAILING ADDRESS Riverside Same CITY STATE ZIP CODE AREA CODE/PHONE A1twh aMborml /7Lbmw#monaQp WW*AabeW con& wGian.+tl wta. 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 pedury under the laws of the State of California that the foregoing Is true and Correct. Executed on 10 -02 -00 By �[ r !owu of SU RER oR AsswANT TFwARER 10 -02 -00 Exam,ited on (::� DATE BY SIONATUREOFOONTROILNGOFF"HOLDER ,CANDIDATE OR STATE MEASURE PROPONENT Exsarted on DATE BY SIONIATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Examded on By DATE SoWww FFPC Form 410 (SM) For Tachnleal Assistance: 91IM22 -6080 ~~ X p 3 B ~ ~ ~ ~ ~ o s ° ~° ~ c ~ ~ °° o ~€ ~ s o ~ ~ w a~ s ~ ~ g c~ ~ ~ g~ O £ ~ °' E ~ O V ~! a i ~ ~ ~~ E~ 8 C ~ ~ 9 ` c O ~ z O ~ 8 ~ ~ ~ y f/J OC a 4 $ o ~ o N 0°1 LL ~ ,¢~. ~j ~_ ~3 z ff f6 7 U N N 0 V U N n N E U C 7 O U r y o s 0 z Q_ ~ c O O 2 s~ ~s ~~ Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee TYPn or Prlrn In Ink oa Bump Q , Statement Type ® Initial ❑ Amendment ❑ Termination — See Part 5 +EP7 For OftW u» ONy i Nat yet queNtted [3 o or List I.D. number: List I.D. number: /t-L- II` ' 09 100 �� �� c o y -4 � Date quallAed as oomm)ttee Date qualWad so committee Date of Terndnstlon 0. 1. Committee Information 2. Treasurer and Other Principal Officers • NAME OF COMMITTEE NAME OF TREASURER Jeanne E. Roberts ADDRE Committee to Re -Elect Ron Roberts MAILIN 41 4114 14 � 0 Avenida Verde STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA COOE,"ONE 41140 Avenida Verde Temecula CA 92591 (909) 676 -2004 CITY STATE ZIP CODE AREACOOEIPHONE NAME OF ASSISTANT TREASURER, IF ANY Temecula CA 92591 (909) 676 -2004 MAILING ADDRESS MAILING ADDRESS (IF DIFFERENT) Same CITY STATE DP CODE AREA CODE /PHONE OPTIONAL: FAX /E-MAILADDRESS FAX 909 693 -0956 e -mail: rroberts(L'D NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE Riverside Same MAILING ADDR • CITY STATE ZTP CODE AREA CODE/PHONE A&whdadit. j riepproplW*/ 3. VerMlcatlon I hays used all reasonable dillgence in preparing this statement and to the beet of my knowledge the information contained herein is true and complete. I certify under penally of perjury under the laws of the State of Callfomia that the foregoing Is true and correct. Exaoutedon 10 -02-00 W `, - TU OF TREASURER OR ASSISTANT TREASURER Executed on 10 -02 -00 DATE SIiN� k TURE OPFI�HOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed On DATE By SMINIATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT Executed on BY DATE SIGINATURE OF 00617 ROLLING OFF;CEHO-DER, CANDIDATE, OR STATE MEASUPIE PROPONEW FPPC Pam 410 (a/ae) For Technical Asalstanoa: 01NW -5 B0 0 0 N I6 7 U N N H O w U •~ ! 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