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Home My WebLink About410s Statement of Organization WHERETO FILE: STATEMENT OF ORGANIZATION M10-p Recipient Committee C / t File original and onempyofthisformwith: {.IFORNIA q- J U Secletaly of State IR t office of the Secretary of State ffOfSM.€ (suwenlmrm lode Srl uuns 84 10 1- 8410 3) O� Political Reform Division at the State of California r "� r PO Box 1467 For Official Use Only Amendment Sacramento.CA958121467 opI ❑ Check box If an Amendment And, if applicable, file one copy of this form with: SEP 199'4 Type or Print in Ink and enter I D number: The uty or county officer, if any, wno lecelves the committee's original campaign disclosure SEE INSTRUCTIONS ON REVERSE # statements. I Committee Information 11 Treasurer and Othe Dale Qualified as NAME OF TREASURER: ,W ommlttee: „a n,.D.Y.Ye.,1 09 -01-94 ❑Check box if not yet qualified Joseph J. Kuebler NAME OF COMMITTEE: MAILING ADDRESS: Committee To Elect Karel Lindeman 155 E. 4 th St., Ste. 230 CITY STATE ZIP CODE AREA CODE /DAYTIME PHONE ADDRESS OF COMMITTEE: (NOT P.O. BOX) NO AND STREET Perris CA 92570 (909)657 - 2141 43500 Ridge Park Drive, Ste. 101 NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S): CITY STATE ZIP CODE AREA CODE/ PHONE NUMBER Temecula CA 92590 (909)676 -6112 MAILING ADDRESS: COUNTY OF DOMICILE: COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE: R1V0LSlde CITY ' STATE ZIP CODE AREA CODE /DAYTIME PHONE MAILING ADDRESS: (IF DIFFERENT) NO. AND STREET OR P O BOX CITY STATE ZIP CODE AREA CODE/ PHONE NUMBER Attach additional information on appropriately labeled continuation sheets. Disposition of Surplus Funds You must specify what disposition will be made of leftover campaign funds, if any, at termination. donated to a local charity IV Verification I have used all reasonable diligence in preparing this statement and to the best of my knowledge the inform t, n ontained 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 At TIRE 44 Cv C-4 B Jose ph J. Kuebler DATE CITY AND STATE Of ELEA Executed on � !.� At � // By — � Li Memmis re UAIf CITY AND STATE 1 4 URE' IINL OIHCEHOLDER,CANDIDATE. OR STATE MEASURE PROPONENT E xecuted On At By DATE CITY AND STATE SIGNATURE Of CONTROLLING OFFICEHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT Executed on At By PATE CITY AND STATE SIGNATURE 01 CONTROL LING OUT ICEHOI DER, CANDIDATE, OR STATE MEASURE PROPONENT I(P,ra1Rl.11llxl ltl lll,llit ll, I't Hn uq1 ID 111111'n RSnn ,nU11111,,I ...... ..IIIx1 ,lII ...... MMC I T)I. .... . N1 On C 41AI'MC.N 1 _ I C_AI_ _D_R_ ACT _SCI11111X1 PROVISIIln10111111 '01111 . State of California Fair Political Practices Commission Instructions for STATEMENT OF ORGANIZATION Statement of Organization f IFphNia Part I. Committee Information: Part III. Disposition of Surplus Funds: The "date qualified" as a committee is the date that the The committee must specify how leftover funds, if any, will committee received contributions totaling S 1,000 or more be spent when the committee is ready to terminate. For during a calendar year. If a Form 410 is filed prior to receipt example, the committee may want to donate leftover of $ 1,000 in contributions, check the box "Not yet funds to a charitable organization. However, there are � talified." Once the committee qualifies, an amended restrictions on the types of expenditures that can be made rm 410 must be filed to report the "Date Qualified as a from campaign funds. Refer to the "Restrictions on Use of Committee." Campaign Funds" section of the Information Manual on Provide the full name of the committee. A committee may Campaign Disclosure Provisions of the Political Reform Act for detailed information. use only one name. The name may not be an acronym or outer abbreviation. Part IV. Verification: Special rules apply for "sponsored committees." The Form 410 must be verified and signed by the (See Part V.) committee treasurer. If this committee is controlled by an If a committee supports or opposes a ballot measure as its officeholder, candidate, or state ballot measure principal activity, all required references to the committee proponent, the officeholder, candidate, or proponent must must include the statement, "Committee For also verify and sign the statement. If a committee is Proposition /Measure ," if supporting a measure, or controlled by two or three officeholders, candidates, or "Committee Against Proposition /Measure ," if opposing proponents, each must sign the statement. If more than a measure. three officeholders, candidates, or proponents control a committee, one of them may sign the statement on behalf The committee's street address must be reported. A post of all controlling officeholders, candidates, or proponents. office box is not acceptable. The committee's mailing address must also be reported if it is different from the committee's street address. A post office box is acceptable for the mailing address. Part II. Treasurer and Other Principal Officers: Enter the treasurer's name and a daytime telephone number. If the committee has principal officers other than the treasurer, such as a president, secretary, or chairperson, list each officer's full name, position held, and address. (Use an appropriately labeled attachment if ne(essary.)