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HomeMy WebLinkAbout410s RECEIVED Statement of Organization 0 20 +e� STATEMENT OF ORGANIZATION OCT Recipient Committee Type or print in ink IL Date Stamp I ' Statement Type CITY CLERKS 11MIPT. E p,�D F, o state ❑ Initial ® Amendment ❑ Termination —See PN 0 a O �De O� C pfn�a For Official Use Only Not yet qualified ❑ or List I.D. number: List I.D. number: the e S . # 1236008 Date qualified as committee Date qualified as committee Date of Termination 0� S tate (If applicable) 1. Committee Information 2. Treasurer and OP r rincipal Officers NAME OF COMMITTEE NAME OF TREASURER Committee to Elect Chuck Washington City Council 2012 Kathy Washington STREETADDRESS (NO P.O. BOX) 31205 Kahwea Rd. STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE 31205 Kahwea Rd. Temecula CA 92591 951 699 -5706 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Temecula CA 92591 95 -5706 STREET ADDRESS (NO P.O. BOX) MAILING ADDRESS (IF DIFFERENT) CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/ E- MAILADDRESS 951 699 -7786 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 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 knowled the i r i n 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. i Executed on 9/20/12 DATE URE OF TREASUVER OR ASSISTANT TREASURER 9/20/12 Executed on (By DATE SIGNATURE O N OLLING OFF (DATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATU E OF NTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (April/2011) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee ®' , INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER Committee to Elect Chuck Washington City Council 2012 1236008 4. Type of Committee Complete the applicable sections. ;g • 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 Chuck Washington City Council Temecula 2012 ❑ 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 BANKACCOUNT NUMBER Pa Western Ban 951 587 -5200 1 , 2176354 ADDRESS CITY STATE ZIP CODE 27541 Ynez Rd. Temecula C 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 N0. OIL 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 (April /2011) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Statement of Organization STATEMENT OF ORGANIZATION Type or print in ink Date Stamp Recipient Committee • - , Statement Type ❑ Initial ® Amendment ❑ Termination — See Part 5 For official Use Only Not yet qualified ❑ or List I.D. number: List I.D. number: r4&CEIVED # 1236008 # OCT 0 12012 Date qualified as committee Date qualified as committee Date of Termination /�� �p�� (If applicable) bl IFY C�($ DEPT. 1. Committee Information 2. Treasurer and Other Principal Officers C-efy rte "' °b �`•�` NAME OF COMMITTEE NAME OF TREASURER Committee to Elect Chuck Washington City Council 2012 Kathy Washington STREETADDRESS (NO P.O. BOX) 31205 Kahwea Rd. STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE 31205 Kahwea Rd. Temecula CA 92591 951699-5706 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Temecula CA 92591 95 -5706 MAILING ADDRESS (IF DIFFERENT) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX/ E- MAILADDRESS 951 699 -7786 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 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 knowled the i ation 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 9 / K6W&i -- DATE �� URE OF TREASLMER OR ASSISTANT TREASURER 9/20/12 Executed on By DATE SIGNATURE 0 CON OLLING OFF (DATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATU E OF NTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (April /2011) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) i , -. Stateanent of Organ6zatioro STATEMENTOF ORGANIZATION Recipient Comrnittee • ' � � 1 .- INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I,D. NUMBER Committee to Elect Chuck Washington City Council 2012 1236008 4. T�/p@ Of COII'1Riltt@@ 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 affitiated or check "non-partisan." . If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. NAME OF CANDIDATEIOFFICEHOLDERISTATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IFAPPLICABLE) YEAR OF ELECTION PARTY QX Non-Partisan Chuck Washington City Council Temecula 2012 ❑ Non-Partisan . List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIALINSTITUTION AREACODE/PHONE BANKACCOUNTNUMBER Pacific Western Bank 951 587-5200 2176354 ADDRESS CITY STATE ZIP CODE 27541 Yn Rd. T C 92591 . •� . Primarily formed to support or oppose specific candidates or measures in a single etection. List below: CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISOICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 470 (Apri1/2011� FPPC Toll-Free Helpline: 8661ASK-FPPC (866I275-3772) �� � ` Statement of Organization STATEMENT OF ORGANIZATION Recipient Corv�mittee � � ' � � 1 .- INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D. NUMBER Committee to Elect Chuck Washington City Council 2012 1236008 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 N0. AND STREET CITY STATE ZIP CODE • . . . ❑ __.__I�J Date qualified 5. T@�fYlllla�l011 R@tBlBlf@Ill@Il'tS By signing the verification, the treasurer, assistant treasurer and/or candidate, o�ceholder, or proponent certiiy that ali 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 (ApriU2011) FPPC Toll-Free Helpline: 866/ASK-FPPC (866l2753772) Statement of Organization Type or STATEMENT OF ORGANIZATION Recipient Committee print in ink Date Stamp Q Ty ® �,A BILE 1 3 Statement T Yp ❑ Initial Amendment ❑ Termination — See Part 5 CEIVE iti to For Official Use Only Not yet qualified ❑ or List I.D. number: List I.D. number: ant a O ffice of the Secretary Of St # 1236008 # of the State of Cahfornta 2 f >t ►1 AUG 14 2012 Date qualified as committee Date qualified as committee Date of Termination 5�W E i) I f (' r L I I ` 1V (If applicable) DEBRA ��� 1. Committee Information 2. Treasurer and Oth I 1 ffI -_ rs ►I Ir_ 20 NAME OF COMMITTEE NAME OF TREASURER Committee to Elect Chuck Washington 2012 Kathy Washington G ill= DEPT. STREET ADDRESS (NO P.O. BOX) 31205 Kahwea R d. STREET ADDRESS (NO P.Q. BOX) CITY STATE ZIP CODE AREA CODE /PHONE 31205 Kahwea Rd. Temecula CA 92591 951 699 -5706 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Temecula CA 9259 951699 -5706 MAILING ADDRESS (IF DIFFERENT) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX/ E- MAILADDRESS 951 699 -7786 NAME OF PRINCIPAL OFFICER(S) COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE STREET ADDRESS (NO P.O. BOX) Riverside CITY STATE ZIP CODE AREACODE/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 e/e / Z' By l DATE l SURER OR ASSISTANT TREASURER Executed on �/ Ir 2— By DATE SIGNATURE OF CONT U01 ING 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 (April /2011) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) S STATEMENT OF ORGANIZATION Statement of Organization Recipient Committee � 1 INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER Committee to Elect Chuck Washington 2012 1236008 4 . Type of Committ 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 X❑ Non - Partisan Chuck Washington City Council Temecula 2012 ❑ 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 . BANKACCOUNT NUMBER Pacific Western Bank 951587-5200 2176354 ADDRESS CITY STATE ZIP CODE 27541 Ynez Rd. 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.(ApriU2011) FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661275 -3772) Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee • ' a INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D. NUMBER Committee to Elect Chuck Washington 2012 1236008 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 (April /2011) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772) Statement of Organization STATEMENT OF ORGANIZATION Type or print in ink Date Stamp Recipient Committee 0 - t Statement Type ❑ Initial ® Amendment ❑ Termination — See Part 5 RECEIVED For Official Use Only Not yet qualified ❑ or List I.D. number: List I.D. number: AA,,'' f1V� 1.4 2012 # 1236008 # ITY cumin Alwr. Date qualified as committee Date qualified as committee Date of Termination Ce ? 7 rcc&s (If applicable) 1 � 1 .0M. C.J., 1. Committee Information 2. Treasurer and Other Principal Officers NAME OF COMMITTEE NAME OF TREASURER Committee to Elect Chuck Washington 2012 Kathy Washington STREET ADDRESS (NO P.O. BOX) 31205 Kahwea Rd. STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE 31205 Kahwea Rd. Temecula CA 92591 951 699 -5706 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Temecula CA 92591 95 -5706 MAILING ADDRESS (IF DIFFERENT) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX/ E -MAIL ADDRESS 951 699 -7786 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 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. A Ali it Executed on p DATE URER OR ASSISTANT TREASURER Executed on 8 ( 7 ' By DATE SIGNATURE OF T L ING 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 (ApriU2011) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee CALIFORNIA FORM INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER Committee to Elect Chuck Washington 2012 1236008 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 ❑X Non- Partisan Chuck Washington City Council Temecula 2012 ❑ Non - Partisan • List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION AREACODE /PHONE BANK ACCOUNT NUMBER Pacific Western Bank 951 587 -5200 2176354 ADDRESS CITY STATE ZIP CODE 27541 Ynez Rd. 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 (April /2011) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee C41LIFORNI INSTRUCTIONS ON REVERSE 1: FORM Page 3 COMMITTEE NAME I.D. NUMBER Committee to Elect Chuck Washington 2012 1236008 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 Small bontributor Committee ❑ _J_J 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 (April /2011) FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -3772) ^ Statement of Organization Type or print in ink STATEMENT OF ORGANIZATION Recipient Committee RE L: EJ% FILE in the office of he Secretary of St Statement Type ❑ Initial Amendment ❑ Termination — See Part 5 f the State of Califo ForOfticial Use Only Not yet qualified ❑ or List I.D. number: List I.D. number: AUG 14 2008 # # 7 EBRA 130WEN S Crotary of State Date qualified as Committee Date qualified as committee Date of Termination (If applicable) 1. Committee Information 2. Treasurer and Other Principal Officers NAME OF COMMITTEE NAME OF TREASURER d'MM i ee - re , Ear /c� W4Si- loa(To-j KAT9 W1,45 P1 tAJ GTb AJ STREET ADDRESS 3 4 H (rY16 X STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 3 I 1 oS KAN LVE A }Z.D . 7Z5 art e GU L4 QZ.EVI 95 / 6PY- 5 7 0,�, CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY - re W E 00 LA 0A STREET ADDRESS MAILING ADDRESS (IF DIFFERENT) CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX/ E -MAIL ADDRESS 9 QQ 7 78p �UC��G,r/�Sy��G ��/ �g�7Tf fL /^//� N AME 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 f2 l ✓�i�S /pc 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 la 7s oft a State of California that the foregoing is true and corre t. Executed on By DA SIG _SURER OR ASSISTANT TREASURER Executed on By / DATE SIGNATURE OF CO LING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By RO 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/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Z N `,(W~ w p 6 N Q z O O ~ N O N O L Q N V O O O U LL m m Eldi ^M^,, p Al W•• m1V J C C y N LLY °m 0 o w N U m z z ae Y q Z LL 1 S- O Z C O U G d r OW = U ~ NJ d J w KQ m y ~ W ~ O ~U LL LL N m O ~ O ha .o E m a tQ~ i° N EE > ~ F4 ttJnn Q a `i Z ~ Z LL r' d N 9 ~ O O 00 b c U ~K 0 o a w ~ io w r ~ tCl ~ L_ 00 ~ O (p N C ~U U L O W V m u U Z d J `v`J r o a E m N° - \ o ~ rLL ~l_ E rn w~ m Om 8 m O J Ow v - c wz a m~ W Z U w W J N C UO U N m rU - m 7 Q IO G W Z p W W Z N O 9L E N c c F' w c a o U m c v wp m p m V\ W~ p O ``Ai U C U U U j p • N Z ~ N ~ . m U N U W l0 N m d m ~ $ m y W J~~ m N y ~ N C ^v r~q m y F' N 6 O V m z w o r o a E j `o O < m c E m c o 1,fr\1~, v_ c a m w l`~ u•i C C O N W t'~ C N O V 0 N V a o U U j m L pC W 1~`J m J ~ ' l0 o J m t 0 `m V E m U 0 ~ O F J m a d E o w E ~ m m O \~'C_J` 0 a N U r L T = `v L Z aJ O r N C C L C U V`` C O W E w S+ Sc C ul j of O O _ 0 E W C o` Q E Q V~ O n• O ~ N Z U O V rc > G O E m Z W U N E E O N Z W C C m w c c on Eo o c LL a E d o W m :5 :E N o N ° a 0 ':3 y Z o a f Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee Type or print In ink Date stamp W . IRECEIVEC Statement Type ❑ Initial Amendment ❑ Termination - See Part 5 For Official Use Only Not yet qualified ❑ or List I.D. number: List I.D. number: � 2� 600 � AUG # # 12 200 CI TY - CLERKS pt. Ga�Y Date qualified as committee Date qualified as committee Date of Termination (If applicable) "#-w 1. Committee Information 2. Treasurer and Other Principal Office NAME OF COMMITTEE NAME OF TREASURER �ort�ti / ,JCTe�✓ "Tl!}L Rtr45q t,4G G 76 nl STREET ADDRESS 3 ,4y XAFX STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 3 I zo5 KAM t t, /E A }Z,D . 7Z-: artt GU 4-, Q2.'�V/ 95 6W- 5 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY T E W E 60 LA OA STREET ADDRESS MAILING ADDRESS (IF DIFFERENT) CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS 7 7 O�o j lyl/ /aT,V e7l -1A 'tC 6 N AME 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 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 la 7s of t e State of California that the foregoing is true and corre t. Executed on By A I%"L_. u'�4UAA& 9 ATr= SIG __SURER OR ASSISTANT TREASURER Executed on W/Z/ B y y SIGNATURE OF CO RO LING OFFICEHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on B DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (January/05) FPPC Toll -Free Helpline: 866lASK -FPPC (866/275 -3772) 4 J N C O U d qa U n m d m E 0 U d ~C+ CG G U 0 d a d C O n O m N m d E m fl N O d d V V C C U O d 0 U w O O (p ~ T d Q d 8` U T m C d w O m d E E d j m.. $ •c N N J V W J J OQ W2 sa O°¢ N S W Om N~ W oz uV o K OF J p f W w o W J U z w 0 ~Q 3 0 a N J z O r p NW KQ NaJ Q K O~ ~z o'o OV JR W)p OU Sp O J Z OU N Wf VN LLO OW -0 W J FU oz O Q U N N or Z~ N y ~r C A N O av Ea G LL LLY UQ a, am LL ~ 0 C a m 2 m LL F U a a LL r RECEIVED A.NI) FIB AIEMENTOFORGANtzATION Statement of Organization Type or print In Ink 21 'J- In the a Recipient Committee f the Stat ,a iiornia t ' On Statement Type E] Initial © Amendment ❑ Termination — See Part 6 NO V 1 5 lUU For • OMdal Use ly Not yet qualified ❑ or List I.D. number: List I.D. number: KEVIN ELLEY # 1236005 # , Secretary of Sta Date qualified as committee Date qualified as committee Date of Termination -01"AP Pon (If applicable) ' I. Committee Information 2. Treasurer and Other Principal Officers DE ff NAME OF COMMITTEE NAME OF TREASURER C 1 6 2OO't /. Committee to Elect Chuck Washington Kathy Washington STREET ADDRESS ':ITY CLERKS 31205 Kahwea Rd. STREET ADDRESS (NO PO. BOX) CITY STATE ZIP CODE AREA CODE /PHONE 31205 Kahwea Rd. Temecula CA 92591 (951) 699 -5726 CITY STATE ZIP CODE AREA CODE /PHONE NAME OF ASSISTANT TREASURER, IF ANY Temecula CA 92591 (951) 699 -5726 STREET ADDRESS MAILING ADDRESS (IF DIFFERENT) CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS (951) 699 -7786 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 Nov. 9, 2004 g�, i1 I I `- - DATE E OF RER OR ASSISTANT TREASURER Executed on Nov. 9, 2004 DATE SIGNATURE OF CONTRCl Ll OFFICE NDIDATE, OR STATE MEASURE PROPONENT Executed on gy DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on g DATE SIGNATURE OF CONTROLLING OFFICFHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT FPPC Form 410 (Jan/03) FPPC Tnll -Fran HaInl(na: R661ASK -FPPC Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee Type or print in ink Date Stamp I � Statement Type ❑ Initial © Amendment ❑ Termination — See Part 5 ' For Official Use Only Not yet qualified ❑ or List I.D. number: List I.D. number: V _ 9 2004 # 1236008 # NO CI CAS DF.PTj� Date qualified as committee Date qualified as committee Date of Termination r � r_ P (" applicable) +�'�Or► CO.Ji 1ak- 1. Committee Information 2. Treasurer and Other Principal Officers NAME OF COMMITTEE NAME OF TREASURER Committee to Elect Chuck Washington Kathy Washington STREET ADDRESS 31205 Kahwea Rd. STREET ADDRESS (NO PO. BOX) CITY SLATE ZIP CODE AREA CODE /PHONE 31205 Kahwea Rd. Temecula CA 92591 (951) 699 -5726 CITY STATE ZIP CODE AREA CODE /PHONE NAME OF ASSISTANT TREASURER, IF ANY Temecula CA 92591 (951) 699 -5726 STREET ADDRESS MAILING ADDRESS (IF DIFFERENT) CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS (951) 699 -7786 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 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 Nov. 9, 2004 1 4 QAD " DATE G E OF_ RER OR ASSISTANT TREASURER Executed on Nov. 9, 2004 (� DATE SIGNATURE OF CONTROLU OFFICER DIDATE, OR STATE MEASURE PROPONENT Executed on DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on � DATE SIGNMURE OF C014TROLLING OFFICEHOLDER, CANDID)VE, OR STATE MEASURE PROPONENT FPPC Form 410 (Jan/03) FPPC Toll -Fran Halnlina: 8861ASK -FPPC Statement of Organization RECEIVED AND FILED S TAT EMENTOFORGANIZAT10N Recipient Committee �— �3 Type or print in Ink la3�oo I'OLITI OFFICE F SECRE A STATE CALIFORNIA � , •- Statement Type Initial Amendment Termination — See Part 5 JUN 2 2 Z 0 01 For Orti cial Use Only Not yet qualified 0 or List l.D.number: List I.D. number: RECEIVED #_ # BILL JONES CA SE RETARY OF STATE I JUL 1 7 2001 Date qualified as committee Date qualified as committee Date of Termination (If applicable) CITY CLERKS ID 1. Committee Information 2. Treasurer and Other Principal Officers NAME OF COMMITTEE NAME OF TREASURER I �D►M AA t TFeE: TZ E Lt CT C �! -l �/�/ ASN /A!G `(v ti! U L- IE ST DcJs E STREET ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 3 (2D 5 (Lq till t�� . E rut= C u L- ra C /k q� 5 �� �- ��� 9 lL 4 - 1 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY i EMr C u L-A C STREET ADDRESS MAILING ADDRESS (IF DIFFERENT) 7 - L �'{ �� �I��C� I�IJ G� - T(. 0&If Q -A. e i-1 "1 / � Z CITY STATE ZIP CODE AREACODE /PHONE OPTIONAL: FAX /E -MAIL ADDRESS 0 6q ) Qq 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 , VEr-s ( DE 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 Califomia that the foregoing is true and correct. Executed on (�' / By ATE A RE OF R OR ASSISTANT TREASURER Executed on DATE SIGNATURE D By �� �' C ` ° � ` - SIGNATURE OF CONTROLLING OFT: EHOLDER. 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 (Jan/01) FPPC Toll -Free Helpline: 868/ASK-FPPC s c w i i b 9 1 i ~ f fill 9 U ~Z W I a 5 °I1 0 ski YI 2 'I 0 c