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HomeMy WebLinkAbout410s Statemento Organization WHERE TOFILEt !�" r o t STATEMENT OF ORGANIZATION R 't;t- I'drdlt SI. a. RecipientCommlttee '33 File original and one copy of this form with: IRte office of the Se0f2�dty0lState (Government Code Sections 84101 - 84103) Secretary of State' 01 the - State 01 Uif0f01a Political Reform Division prr P.O. Box Amendment to, A Sacramento, CA 95812-1467 OCT Y; 7 1996 D U El Check box if an Amendment And, ifa ap file one co of thisform with: U E _." Type or p r i nt in ink P y YP P and enter I.D. lD number: The city or county officer, if a who receives the Secretary Of a JAN O 7 committee's original campaign disclosure BLL 'ON", 1997. - SEEINSTRUCTIONSONREVERSE statements. 8 I Committee Information II Treasurer and Other Principal Officers Date Qualified as NAME OF TREASURER Committee (Month, Day, Year) 9 -30 -96 ❑ Check box if not yet qualified nFeFrr n TTrnnfeg _I' AME OF COMMITTEE MAILING ADDRESS COMMITTEE TO ELECT STEVEN FORD 43500 RIDGE PARK DR,, STE. 104 - CITY STATE ZIPCODE AREA CODE /DAYTIME PHONE ADDRESS OF COMMITTEE (NOT P.O. BOX) NO. AND STREET TEMECULA CA 92590 (909)676 -3013 43500 R P ARK D R., STE. 104 NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S) CITY STATE ZIPCODE AREA CODE/ PHONE NUMBER TEMECULA CA 92590 (909)676 -3013 MAILING ADDRESS COUNTY OF DOMICILE COUNTY WHERE COMMITTEE 15 ACTIVE IF DIFFERENT RIVERSIDE THAN COUNTY OF DOMICILE CITY STATE ZIP CODE AREA CODE/DAYTIME PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX SAME AS ABOVE CITY STATE ZIPCODE AREA CODE/ PHONE NUMBER Attach additional information on appropriately labeled continuation sheets. III Disposition of Surplus Funds You must specify what disposition will be made of leftover campaign funds, if any, �t termination. is DONATE TO A LOCAL CHARITY IV 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 ct. Executedon 9 - 96 A TEMECULA CA By DATE CITY AND STATE DER THOMAS SIGNAT RE OF TREASURER Executedon 9 -30 -96 At TEMECULA CA By/ DATE CITY AND STATE .. I ATURE OF TROLING OFFICEHOLDER. CANDIDATE, OR STATE MEASURE PROPONENT Executed on At By TEVEN ORD DATE CITY AND STATE " SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on At By DATE CITY AND STATE SIGNATURE Of CONTROLLING OFFICEHOLDER, C ANDIDATE, OR STATE MEASURE PROPONENT FOR INFORMATION REQUIRED TO BE PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT OF 1977, SEE INFORMATION MANUAL ON CAMPAIGN DISCLOSURE PROVISIONS OF THE POLITICAL REFORM ACT _ State of California Fair Political Practices Commission Statement o Organization STAT FORGANIZATION Recipient Committee Type or print in ink JAN 8 1991 Page Z NAME OF COMMITTEE R(IF AMENDMEN ) COMMITTEE TO ELECT STEVEN FORD V Type of Com mittee Complet Th is Statement: COMPLETE THE APPLICABLE SECTION(S). MORE THAN ONE CATEGORY MAY BE APPLICABLE TO YOUR COMMITTEE. SEE R F IMPORTANT INFORMATION AND D OF THE COMMITTEES LISTED BELOW. Controlled Committee • If this committee is controlled by one or more officeholder( s) or candidate(s), list the name of each controlling officeholder or candidate. Also list the elective office sought or held, and district number, if any, for each individual. If this com m ittee is controlled by one or more officeholder(s)or candidate(s) for pa rtisa n off ice, list the politica l party with which each officeholder or ca ndidate is a ffi liated. An officeholder or ' candidate not holding or seeking a partisan office must indicate "non - partisan." If this committee is controlled by a state measure proponent, list the name of the state measure proponent. If this committee is controlled by more than one state measure proponent, list the name of each state measure proponent. • If this committee actsjointly with another controlled committee, list the name and identification number of the other controlled committee. NAME OF CANDIDATE/ OFFICEHOLDER /STATE MEASURE PROPONENT /COMMITTEE PARTY ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) STEVEN FORD NON ORTISAN CITY COUNCIL - TEMECULA, CA Primarily formed Committee If primarily formed to support or oppose specific candidates or measures, list the candidates or measures below: CANDIDATE'S NAME OR MEASURE'S FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CAN (INCLUDES DISTR S C O T NO., CITY OR COUN AS APPLICAIB CHECK ONE SUPPORT OPPOSE I SUPPORT OPPOSE General Purpose Committee If not formed to support or oppose specific candidates or measures, check ONE box to indicate if this is a: ❑ CITY Committee or ❑ COUNTY Committee or ❑ STATE Committee � VIDE BRIEF DESCRIPTION OF ACTIVITY Sponsored Committee I Provide the naMe and address of the sponsor. If the committee has more than one sponsor, provide names and addresses on appropriately labeled attachment. NAME OF SPONSOR: INDUSTRY GROUP OR AFFILIATION OF SPONSOR: ADDRESS OF SPONSOR: NO. AND STREET CITY STATE ZIP CODE Broad Based Committee If this is abroad based committee and wishes to make contributions to candidates in excess of the $2,500 contribution limit in connection with a special election, check the box below and enter the date on or before which the committee qualified as a broad based committee. (If the committee is not a broad based committee, or does not wish to make contributions in excess ofthe$2,500 limit, do not complete this section.) . ❑ Check box if this is a broad based committee. Enter the date on or before which the committee qualified as a broad based committee: (MOnfM1; Day, Year) Check box if this committee no longer qualifies as abroad based committee. 3fatem6nt of Organization WHERE TO FILE: • STATEMENT OF ORGANIZATION Recipient Committee File originaland one copy of this form with: Date Stam (Government Code Sections 84101- 84103) Secretary of State O Political Reform Division Amendment P.O. Box 1467 For Official Use Only Sacramento, CA 95812 -1467 3 1996 Ty p rint in ink ❑ Check box if an Amendment And, if applicable, file one copy of this form with: OCT tr YP P and enter I.D. number: The city or county officer, if any, who receives the committee's original campaign disclosure SEE INSTRUCTIONS ON REVERSE X statements. I Committee Information II Treasurer and Other Principal Officers Date Qualified as NAME OF TREASURER Committee (Month, Day,Year) 9 -30 -96 ❑ Check box if not yet qualified DEREK Tl TT- T(1MAC NAME OF COMMITTEE MAILING ADDRESS COMMITTEE TO ELECT STEVEN FORD 43500 RIDGE PARK DR, STE- 104 CITY STATE ZIPCODE AREA CODE /DAYTIME PHONE ADDRESS OF COMMITTEE (NOT P.O. BOX) NO. AND STREET TEMECULA CA 92590 (909)676 -301 43 RI PARK DR,, STE. 104 NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S) CI CA STATE ZIP C DE AREA CODE/ PHONE NUMBER 92 (909)676 -3013 MAILING ADDRESS COUNTY OF DOMICILE COUNTY WHERE COMMITTEE 15 ACTIVE IF DIFFERENT RIVERSIDE THAN COUNTY OF DOMICILE CITY STATE ZIPCODE AREA CODE/DAYTIME PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX SAME AS ABOVE CITY STATE ZIPCODE AREA CODE/ PHONE NUMBER Attach additional information on appropriately labeled continuation sheets. �Dispositlon of Surplus Funds You must specify what disposition will be made of leftover campaign funds, if any, Ot termination. DONATE TO A LOCAL CHARITY IV 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 ct. Executed on 9 -30-96 At TEMECULA CA B i DATE CITY AND STATE DER THOMA SIGNAT RE OF TREASURER Executed on 9 -30 -96 At TEMECULA CA BY/ E DATE CITY AND STATE I AtUREOFC TROLING OFFICEHOLDER. CANDIDATE, OR STATE MEASURE PROPONENT TEM ORD Executed on At By DATE CITY AND STATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT Executed on At By DATE CITY AND STATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FOR INFORMATION REQUIRED TO BE PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT OF 1971, SEE INFORMATION MANUAL ON CAMPAIGN DISCLOSURE PROVISIONS Of THE POLITICAL REFORM ACT. State of California Fair Political Practices Commission Statement of Organization STATEMENT OF ORGAN IZATiGN Recipient Committee Type or print in ink Page 2 NAME OF COMMITTEE I.D. NUMBER (IF AMENDMENT) COMMITTEE TO ELECT STEVEN FORD V Type Of Committee Completing This Statement: COMPLETE THE APPLICABLE SECTION(S). MORE THAN ONE CATEGORY MAY BE APPLICABLE TO YOUR COMMITTEE. SEE REVERSE FOR IMPORTANT INFORMATION AND DEFINITIONS OF THE COMMITTEES LISTED BELOW. Controlled Committee • If this committee is controlled by one or more of ficeholder( s) or candidate(s), list the name of each controlling officeholder or candidate. Also list the elective office sought or held, and district number, if any, for each individual. If this committee is controlled by one or more officeholder( s) or candidate(s) for partisan office, list the political party with which each officeholder or candidate is affiliated. An officeholder or candidate not holding or seeking a partisan office must indicate "non - partisan." • If this committee is controlled by a state measure proponent, list the name of the state measure proponent. If this committee is controlled by more than one state measure proponent, list the name of each state measure proponent. • If this committee actsjointly with another controlled committee, mittee, listthe name and identification number of the other controlled committee. NAME OF CANDIDATE/ OFFICEHOLDER /STATE MEASURE PROPONENT /COMMITTEE PARTY ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) STEVEN FORD NON CITY COUNCIL - TEMECULA, CA PARTISAN PrimarilyFocmedCommittee If primarily formed to support or oppose specific candidates or measures, listthe candidates or measures below: DATE'S CANDIDATE'S NAME OR MEASURE'S FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CAN (INCLUDE CT NO., CITY OR COUNTY, AS APPLICAB CHECK ONE SUPPORT OPPOSE i SUPPORT OPPOSE I General Purpose Committee sot formed to support or oppose specific candidates or measures, check ONE box to indicate if this is a: ❑ CITY Committee or ❑ COUNTY Committee or ❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY Sponsored Committee I Provide the nd ne and address of the sponsor. If the committee has more than one sponsor, provide names and addresses on appropriately labeled attachment. NAME OF SPONSOR: INDUSTRY GROUP OR AFFILIATION OF SPONSOR: ADDRESS OF SPONSOR: NO. AND STREET CITY STATE ZIP CODE Broad Based Committee If this is a broad based committee and wishes to make contributions to candidates in excess of the 52,500 contribution limit in connection with a special election, check the box below and enter the date on or before which the committee qualified as abroad based committee. (If the committee is not abroad based committee, or does not wish to make contributions in excess of the $2,500 limit, do not complete this section.) . ❑ Check box if this is a broad based committee. Enter the date on or before which the committee qualified as a broad based committee: . (Month; Day, Year) ❑ Check box if this committee no longer qualifies as a broad based committee.