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Stat�?rrtent of Organization I GI'� O � LOI De2ESIdR1'� � .
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I . '. �PPPC Form 430(lan/2016)
� � , FPPC Advice:advice@fppc.ca.gov(B66/2753772)
www.fppc.ca.gov
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Stat�ment of Organization • - � ,
RecipienY Committee • - '
INSTRUCTIONS ON REVEFSE � .
vage I
COMh11TT:LIC�M. LC.":UM9=R ,
���M �- ���2 �o�- TeMcc��.A Gt-� Cov�c�t 20��, 13�,�4�02
• All committees must Iist[he financial Instltutlon where the campaign bank account Is located.
p'4FSE OP BNANUALMSiiTU?10:'1 - %�di4iOBF(PM1ON2 9RN'R?CCCIUY.T9Vb19F�
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aDD4=i5 CiTY � SL'TE ZI�COOE
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4.�Type of�@omm�ttee Complete the applica6le sect�ons �, _�s,�������- x���� ,nW��,,���„_�K� �,'��� ,;�, g�„ „���.�u ��+;r� '€�:'�„��"�'�%„�,,�i:`�
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• List the name of each controlling off9cehold2r,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�viUz whith each officeholder or candidate is affiliated or check"nonpartlzan"
• If this committee ads jointly with another controlled committee,list the name and identlfication number of the other[ontrolled committee.
El`ciTIVE OFFlCE SOVGF:T OP HELD
NAMEOFC�NDIDGTE,%OFFlCcHOtCERjSiAZEFAEdSVFE?ROFCPkNi hflC!l'D'_C6TRIRNUPdBEFIFAPFLICABLEj YEA0.0fElEQION PAFTV
� Nonpartisan
�pl�r� - �� �� TEMew� C�c•1 Cav�c,� 2o�a
❑ Nonpartisan
Primarily formed to support or oppose specific candidates or measures in a single election, List below:
CANDI�ATE{5;N�ME OR A"EdSUF.E�S)Ft/lL i�TIE IID!QUJE EiiIOT NQ OR t'cTicf) CCNDIDGTE(S)OFFlCE SOUGHT OF HELO O'n bMEASVREISUUR15DICTIOPo '
(INQUDE D6TPIR NO.,CITY 00.COUNTV,AS PPCLICABLE� ��p��.
$U?POa;M pvapy=
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iu»04' JP'rCS�
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� FPPC Form 430(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(666/D53772)
www.fppc.ca.gov