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Statem�nt of Organization ,, R CEIVED te51amP , � . � 1
Recipient Committee ��q� AND FILEI, • -
Stateinent Type a��«he�Cfe1ary ot Sta�< Por OHicla�Use Onl
❑Initial � Amendment ❑ TerminaHon—SeePartS MPSfT}g�r�;t���� v
Notyetqua�ifed ❑ or �ist I.D,number. List I.D.number: , RECE�VED
# 1384102 � �UL 2 7 2016
0�13 �2016 �_� _�_� AU6 221016
Dale qualifed as commiflee Date qualified as committee Date of Terminatlon � Cm/C�S
li�aaou<nmel
�1.�Comrtiittee I'n"formativ"fi ` . '� , 2? T�su'�er nd�Ofher.PFinef�'a Officers a. �
NAME Of COMMITTEE ' NAME OF TPEASUNFR
ADAM A. RUIZ FOR TEMECULA CITY COUNCIL 2016 JODY D. NOTTINGHAM
SiflEEi ADOPE55�NO P 0.BO%�
43460 RIDGE PARK DRIVE, STE 240
SiREETA��flE55INOP.O.BO%� CIiV STATE 21PCO�E �flEACODE/PHONE
37985 GOLDEN ROD ROAD TEMECULA CA 92590 (951)296-1698
CRY STAiE ZIV(OOE APEACOOE/PHONE NAMEOFASSISTANTTPEASUflEfl,IFqNY
TEMECULA CA 92591 (951)326-4698 EDWARD A. CHANDLER
MAILING AODRESS(IF DIFFERENT) SiPEET ADONESS�NO P.O.BO%�
40335 WINCHESTER ROAD, STE E140, TEMECULA CA 92591 43460 RIDGE PARK DRIVE, STE 240
FA%/E'MNlA�O0.F55 CITV STATE 21PCOOE A0.EPCO�E/PHONE
ADAM@1STACTIONREALESTATE.COM TEMECULA CA 92590 (951)296-1698
COUNTYOFDOMIQLE IDHISOIQIONWHEPECOMMIiTEEISACtIVE NAMEOFFqINCIPALOFPCER�S)
RIVERSIDE CITY OF TEMECULA
SiflEEi 4DOPE55�NO F O.BO%1 �
��1Y STlSE ZIPCOOE ANEFCOOE/PHONE
F�rtach additional information on appropriately/abeled cantlnuatlon shee[s.
3:' VeYi 'cat�on. : , . ..y,; , >� ,. � . ' . 4�. . .
i have used all reasonable diligence in preparing this statement and to the best of my knowledge the information wntained herein is true and complete. I�r�un�'er �1
penalty of perjury under the laws of the State of California that the fore � is-tcuea.dd corr . —'' —" � �
� '' � ('7
Exemted on 07�2��20�6 gy o'^'� — l�l
DATE SIGNATURE TREASUAENONASSISTANTTNEASURER N C., � �
Exe<uted on 07�2��2��6 gy G T a ;T
��TE SIGNr1Tp FCONTFOLLINGOiFl[EHOLOER,CANOIDATEORSTAiEMEASUflEFqOFONfNT �Go :�J
VJ"-"� -
Execu[ed on By �r—',�- .�' .
DAiE SIGNATUqEOFCONTqOLLINGOFFlCEHOLOER,CANDIDAiE,ORST�TEMEAStIPEPPOPONENT TC.:. , fV
Executed on By
�AiE SIGNAiOPE OF CONTNOILING OFFlCEHOLDEP,CANDI�ATE,OR SiAtE MEASUflE PflOPONENT '
FPPC Form 410(lan/2016)
FPPC Advice:advice@fppc.ca.gov(866/2753772)
www.fppc.ca.gov
�
Statemgnt of Organization • - � � ,
Recipient Committee • •
INSTRUETIONS ON ftEVERSE �
Page 2
:�`l°q'A�I�1`I"�"` RUIZ FOR TEMECULA CITY COUNCIL 2016 i.o.nuMeea
1384102
• All committees must list the financial insHtuHon where the campaign bank account is lacated.
NHmE OF FINANCIALINSTITUTION ANEACO�E/PHONE BNNMpC<OUNTNUMBEP
FIRST CITIZENS BANK (951)506-1271 1064435892
AODPE55 UiY ST�iE 21PCODE
44575 AVENIDA DE MISSIONES TEMECULA CA . 92592
. ., � - v - .
4'.�,;Ty,pe�,ofaCommitEee Complete,the applleable�sections._ , � ' �
• List the name of each controlling officeholder,candidate,or state measure proponent. If candidate or oNiceholder 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 aHiliated or check"nonpartisan:' .
• li this committee acts jointly with ano[her controlled committee, list the name and identification number of the other controlled committee.
- ELECiNE OFFICE SOUGHT OR HEL�
NAMEOFCANDIDATE/OFFICEHOLDER/STATEMEASUREPROPONENT �INCLUDE�ISTRICTNUMBERIFAPPLICABLE� YEAROFELEQION PARTY
� Nonpartisan
ADAM A. RUIZ TEMECULA CITY COUNCIL 2016
. ❑ Nonpartisan
Primarily formed to support or oppose specific candidates or measures in a single election. List 6elow:
CANDIDATE(S�NAMEORMEASURE�S�FULLTITLE�1NCLUDEBALLOTNO.ONLETTER) C�NOIDATE(S�OFFlCESOUGHTORHEL�ONMEASUREIS�JURISDICTION
�INC W OE DISTRIQ NO„QTV OR COUNTV,AS APFLICABLE� CHECK ONE
SUPPOPi OPPOSE
SUVPORT OPPOSE
❑ ❑
FPPC Farm 410(Jan/2D16)
FPPC Advice:advice[alfppc.ca.gov(866/2753772)
www.fppc.ca.gov
Statem�nt of Organization . � -
Recipient Committee � - � �
INSTRU�TIONS ON REVERSE
Vage 3
`Y�:C�A`fJl"p;. RUIZ FOR TEMECULA CITY COUNCIL 2016 '° "°"'aE"
1384102
. -, ..�.�. , ..._.,...._ _. . . -�� � - ,�;
�YrPeRof�@ommiitee �Ico"6��ed1 _ �., � �,µ,„,2;r� ..
�
,.
� Not formed to suppnrt or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee 0 STATE Committee
VflOVIDE BflIEF OESCRIPTI ON OF NCTIVItt
List additional sponsors on an attachment.
M1AME OF SPONSON INOVSiRY GROUV OR ALqIIATION OF SVON50F
STREETAD�0.ESS NO.ANDSTflEEi CITV STATE ZIVCOOE
❑��
DateQuallfied
hT""+T'�S«.9:M` +Re4aL�R*3AK5m"a*SmT."✓`n. 'Y� F��/T{t�+ �yCq
S'�T(8ff111110T:1U�R2GUIG8R1E�1 i , Byslg Ingthe�vetlficationpthetreasuref,assistaMtreasuterandJorcandidate,offi��'eTiolder;o proponen :6ertify;thafall6f'thefo�lowing�`aor�tl 'ons�.ha`e6een'�m :
• This committee has ceased to receive contributions and make expenditures;
• This committee does not anticipate receiving contributlons or making expendi[ures in the future;
• This committee has eliminated or has no intention or ability to discharge all debts,loans received,and other o6ligations;
• 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(lan/2016�
FPPC Advlce:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization DateS[amp , � . ,
Recipient Committee � . � �
StatementType �Initial � Amendment ❑ TerminaHon—SeePartS ForO(ficlalUseOnly
Nolyetqualifed ❑ or Listl.D.number: Listl.D.number: RECE���
#1384102 #
07 13 2016 ��� 25 �
—/—/ /—/ —/—/
Date qUalifed as committee Date qualified as committee Date of Termination
�ilappuaoie� �R1'CLERKS DEPT.
1�Gommitteelnformatio�,��' t �F���.,.;�T��'�'F�'„��'P"���T}"�_2�3Tr,easurer.and�QtherP,qin'cipal�Officers -p,"� +�s
NAME OF COMMITfEE
NAME OG TREASOqER
ADAM A. RUIZ FOR TEMECULA CITY COUNCIL 2016 ,IODY D. NOTTINGHAM
STPEET ADDRE55�NO P.O.BOX�
43460 RIDGE PARK DRIVE, STE 240
STNEETROOflE55(NOP.O.BO%1 CIiY STRTE ZIPCODE ARERCODE/VNONE
37985 GOLDEN ROD ROAD TEMECULA CA 92590 (951)296-1698
CITY STATF 21PCO�E AREACOOE/VNONE NAMEOFASSISTANTTXEASUflER,IFANY
TEMECULA CA 92591 (951)326-4698 EDWARD A. CHANDLER
MRIIING AOOPE55(IF OIFFERENT� STREET AODNE55�NO P.O.BO%1
40335 WINCHESTER ROAD, STE E140, TEMECULA CA 92591 43460 RIDGE PARK DRIVE, STE 240
fA%/E-MRILADDPESS CITV STRTE ZIPCODE qREACOOE/PHONE
ADAM@1STACTIONREALESTATE.COM TEMECULA CA 92590 (951)296-1698
COUNTYOFD�MICILE IUPISDIRIONWHERECOMMITfEEISACTIVE NAMEOFPRINCIPALOFFICERI51
RIVERSIDE CITY OF TEMECULA
STPEETRODRESS�NO P.O.BO%�
��T1' STATE ZIPCOOE ARFACOOE/PHONE
Attach addidonal informotian on appropriately labeled contlnuation sheets.
3�..�/Qri caLl"on r w > s f3. �,� � � � a �"""��„ +� e ne.� ' in,an�+�.` "�.�"'.�"'"�'.r����'^ '���'���'r�
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 fore ' g-istweapd corr .
Executed on �7�2��2��6 gy �
OFTE SIGNFTURE TREASIIRENORN5515TANTTPEASUREP
Execu[ed on 07/20/2016 ey
OATE SIGN T OFCONTROLLINGOFFICEHOlOER,CNN0�0ATE,ORSTATEMEA5U0.EPROPONENT
Executed on gy
OATE SIGNATURE OF CONTROLLING OiiICEHOlOEP,CANOIOATE,OR STATE MERSUPE PROPONENT
Executed on By
ORTE SIGNATUPE OF CONT0.0lLING OFFICEHOLOEA,CANDI�ATE,O0.STATE MERSUflE V0.0PONENT
FPPC Form 410(Jan/2016)
FPPC Advice:advfce@fppc.ca.gov(866/2753772)
www.fppc.ca.gov
X
Statement of Organization . • - '
Recipient Committee • - �
INSTRUCTIONS ON HEVENSE
Vage 2
Y�`�$'%�I�I"�," RUIZ FOR TEMECULA CITY COUNCIL 2016 I.D.NUMBEP
1384102
• All committees must list the financial institution where the campaign bank account is lowted.
NAME OF FINpNCIALINSTITUTION AflEACOOE/PHONE BRNNACCOUNTNUMBEA
FIRST CITIZENS BANK (951)506-1271 1064435892
�AODRESS [ITY STATE 21FCODE
44575 AVENIDA DE MISSIONES TEMECULA CA 92592
4.�'s1Ty,pe_ofdCommittee Complete the applicable,sections t„ „y�e�,��_,����,,�`*"�"fw�,�'r�`��s`�'`�'�y'�'"",� '��' � � � ��t�a��`.�'�y�.�{��
• List the name of each controlling officeholder,candidate,or state measure proponent. If candidate or oNiceholder 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 officeho�der or candidate is affiliated or check"nonpartisan."
• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
ELECTIVE OFFICE SOU6HT OR HELD
NAMEOFCANDIDATE/OFFICEHOLDER/STATEMEASUREPROPONENT (INCLUDEDISTHICTNUMBERIFAPPLICABLE) YEAROFEIECTION PARTY
� Nonpartisan
ADAM A. RUIZ TEMECULA CITY COUNCIL 2016
❑ Nonpartisan
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE�S�NAMEORMEASURE�S�FULLTITLE�1NCLUDEBALLOTNO.ORLETTER� �ANOIDATE�S�OFFICESOUGHTORHELDOflMEASUREIS�JURISDICTION
(INCLUDE DISTRICT NO.,QTV OR COUNTY,AS APPLICABLE) CHECK ONE
SUPPORT OVPOSE
SUYPOPT OVPOSE
❑ ❑
FPPC Form 430(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppaca.gov -
Statement of Organization . � • '
Recipient Committee • - �
INSTRUCTIONS ON HEVERSE
Page 3
`RY�J'�A`fJI""�. RUIZ FOR TEMECULA CITY COUNCIL 2016 I.O.NIIMBEP
1384102
�?Y,Pe of Gommittee: • �a�eo�n�oeai ` i->v ra"�*y�}�q�'�"=5 '1�F=y�s r .:�: .,� a2:ras.y+7 n � � ��t s ::,k,q
Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee❑ STATE Committee
VROVIOE 9RIEF OESCRIPTION OF ACTIVITY
List additional sponsors on an attachment.
NAME Oi SPONSOR INDUSTPY GPOUP OP Pii1LIAT10N OF SVONSOR
STREETADOPE55 NO.RNUSTRfET CITY STATE 21PCOOE
���
Dateyualifletl
5?aTie�mi nation�Requirements;-,t K By signing,[he vedficatlon,the treasurer,�assis[ant,treasurer and/or candidate,officeholder,loyproponent certify�that aII o�theifollowingtondltlans have 6een meP."'�-1i�
• 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(Jan/2016)
fPPC Advice:advfce@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
,_
.:.CCtsG�r Y-v r•••� • ot State , �
�'s��0��� in�he ofOce ot lhe Secretery
� _ a(Ne State ot Califomia �
statement of organization APR 2 i 2016 �pR 14 201fi o3t<Stamp � .
Recipient Committee ��.�.��� �p. � � .
� � 1
�.� ��P91'a ��-
StatementType ❑ Initial � Amendment '— ' "' `Fcroticiaiuseori•:
❑ Terminarion—SeePartS �������
N¢iye?qua6fi:d ❑ nr tist Lq pumber. Lis:I.D.number. � � ���'� � P�i I � 52
� 13a�-1�o2 � Ap� n 7 2D i' . _
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Datequeitledascommittee Catequal edas�o/�,�r,ce wc=/ � �8�' CI.�ROCS ¢91�1��A'%r ��r f���iE�S��E,
ot Terminatian
p�accL:ae'�zi
1� Corrimittee Informat�on��s �,`�����'�'.�„� ��;�����,r�'�-��"�.�s!'��2:-�;Treasurer,ariiiiOtlierPrincip'alEOfficers`�° ����^�*" �';;�,^ _�,��_• ��
_��t�y �. �1�"���CAPrI�
r.ee;;eeaess fNu eo.aox)
A1�AM R t2��� Fo(� \tM�a�.A CiZ�I Cu��+c�� 2oi� y3��,o �.�oc.f Paa�c ��- # 240
STF'ccTAD05E55�Y.06G.R0%I . OH SIDiE 21PfOCE qflE.CGDS;'PiOlv'c
3��1QJS �-�iCI,AC� P-fl� �-�A� TEME�v'�A CA qZS90 qSl .29� 11oG8
Cii{ �50.:2 Zff[CDE 4RE4rpp,1=ifi0YE T.KMECFki515SLlIiTFESSU�EP.!F4HY
TE�Ec„� C� �lisa� 9S� 32e at��� r�w��� c�1aN��E�
idAM1l;i a nOD�:S(Is DiFs REYT) .TS=ETSOv'dF'S(NC F.O,BCc;
�G335 U,\+�C�1tS-�� Q-�P�D , s•t�tt E - l4b TEn�ecv.,�, ('A 925`il �3`i�o '��DL-E Q P�Q�C D�- � Z�19.
fARIEYdcLLAOLF�S . . C:TF STATE :IiCCDE �nEnCO=J`JP?iOFE
A��M e �s��-�oa�tesa�. co� T�nr,�cu�.o. , CA qzs�o c�si 29� 1�9�
COUNTYO€DOId�4fL �gA1<pIC'tGN4YE,RfiOMUiiiE:ISqC➢VE EJ4R1%9FtattJC�PA!Pifli=.nfl �
P_\��(LS1�E Ci��I OF IEMECo�A
- s�;[:na;�ss fn�v.o,ao J
� i:. v-aTi tlatcLE „�_.._.._c._.,..c
Attach additional rnfonnntlon on np�ropria[ely labeled contlnuntia�sheets.
3`E��V21'I C3CIOt1 �ka�e�f�,?. �M��i�I' s � ����.> ivdu+�,�,�. ��'c� ^ ;� +�,�va���,��yhtrr �� `k`� 3 M.�'@r�� E ra :.:� �.�v'k Ih a'' ��x�'„ kS �i�ax �.:JrP� ��:� � >. �2r�pppfl
... .uc _......__., H.....e.�,,..n�.su»..,it�..5iv6.td�3aS3.,..rw,az:,.,.,,a.,.:&..,..u......1.i��et,.„�... �,...c,.....u�e,....L+.l,.�.„„s.�t .r�.Nwsr.,. .�„urn,.r,��.siG�i�iu.Yr s.n,�,a;r.I,t.,a zi...�t . �'. �:' iu,adbuEP.Jk7�u�#t�.S.a7.rn:....�nw,r ,.�r..,,K.,.1+., h�
, I have used ail reasonable diligence in preparing thls statement and to the best of my knowledge the informatioE�contained herein is true and compleee. I certi'ry under '
penalty of perjury under the laws o�the State of Calif nia that the foregoing is[ ue a d correci.
Execatedon � Y' l�J gy ,/�� -
.�TT° / SIG4.iUS:GFTnE-iVF 4Gd45515tiNTi0.E=iJ4E-
Execu;edon ��Il� �o� ZO�V g4' _ .
�"�'T' 9 �'A- :Oe�pfJ .� ❑t' ..FrlEc . _..C.Npi[:A : OReiR� t.4 � rd0`rONENi
Executedon �y - .
DAT� �t[ � �,EOFCGNi0.�� J�.,FFtL:tC�D.F,CFN�ICA�„OnStni�F.EA �: ..^.CFONENi
Ex?cut=sl or� Bv -
.ere �i �. ._acc> x.� .:.tc=:�e . . .. .ne.5s ,_.-en: _..:c.c��;erc ' ' �
. FPPC Form 410{7anJ2016)
� � , FPPC Advice:advice@fppc.ca.gov(866(275-3772�
www.fppc.ca.gov
. X
Statement of Organization - . -
Recipient Committee . - ' �
INSTfiURIONS�NREV:FSE .
vage 2
Nh.tdlil'cE 1:ANIE
r.o-uuwe:a
��l�M � - ��� ��. EMEc�� C�S�1 Co�Nc�� Zot� � �� /U a
• All committees must list the finantlal insHtution where the campaign bank account is lotated.
Ix'4ME Of FlN+RriCIINSiITJIIOR =�ipLEIGnONi dAM:<UOVHTM1ifi.L`E:
�IR�i � �T��f^�5 (J��W�L �S � S�� 12"I� ooiov'1�13��52
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�{�SIS �.fF��oq br" N1� s.S�uacS jCMEc�w� ('A �zS� 2
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4 9T 8:Of5COfft(T11�2�COfT7 �2t0tf18d pjlCd��e�$2Gt10�P' .ri^ �� � (� Y .t� i iR�u .. f£�,ia,Vr`S;*1 �i . �, a y'"„�=.,tr '� Ix;p,� ,�� 5� i..:l�l� t n k`�'� � �nvg.
� .,.�Yp,�,M,,,a...:�.v. x,�,,..p,.. ..���,�?.,.h_.�x�.�...�.,����t�� .�n��,.�;�4;;��, '�' `��`u u" �'�� W, �, � � .z�p �`-u.�a� .,u�.._...� 4i i� r�' ��•
m�} G t�eutla.uu`u... �.a.._.,..:,it.,ww.sa� ev,�uV..w w. ., 'z....�+ .�s� 'c�.»u't�.s,�.u.a.n
• List the name of each convolling officehoider,candidate, or state measure proponent. If candidate or officeholder controlied,also lis[the ele�tive of#ice sought or held,and
.disa ict number, if any,and the year of the efection.
• List the political party with which each officeholder or candidate is atiiliated or check"nonpartisan."
• If this committee acts jointly with another controlled committee,list the na�ne and icEentiHcallon number of the other controlled �ommittee.
� - ELELLNEOFFlCESOUGMTORHELO �
fdAMiQFCat:�Ji�ATiJOFFlCEHGLDERIS?8TEPIEASUAE'�ROPONEIJT (INCLVDE715iR{Qfv'Vh59ERIFAPPLICABLc) YEAROFELECTIOH PARTY -'
`1 `1 � Nonpartlzan
A-. ��1�� 11V �� EMECJ'�-A C��V �OUrJGL ZO��o
❑ Nonpar�san
Primarily formed to support or o�pose specific candielates or Eneasw�es in a single election. List below:
CAR2JI�4icfS�OFFIiE SOLGH i OP,flELD 6ft MfkStiRE�SI)UR601QICN
CANDI7C-5(SS NAM1IE OR fJ�EASVREISE F�AL�:Ttc ZItJCLVDE 3ALLOT N0,OB lE?':'P� �;rv{LUD'.DIS i RIC7 WO..CITY OR COUNTY.AS AGPLIC48LEI �;C+U�tE
' iL':%J�i C9?CSE
❑
SU?=CBi p�?q5=
❑ ❑
FPPC Form 410(Janf 2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
� � I� � �-I� i �Z
,;fatement of Organization ;;, . � DateShmp , � . ,
Recipient Committee ,- 4� � 0
(; • -
StatementType �(Inftial `'"��r�
„C�� ❑ Amen�f ❑ ,TerminaHon—SeePartS R CEIVEDAND�FIL� �� �����s_�y��o�ry
� Not yel qualified �or List i.D.number Ay (��i�tjl�.number: III e otfice M the 9ecre B��ai V 6�� '
�` � �6 FiAR 31 ��" of the State d CaNfoTte
� 201fi
, -
,
� �—,— i�)�;��E"aSl��� MAR 21201B MAR 8
Dalequalifiedascommi�tee Datequa� ee � � Dateo/Terminatlon �y�'rYC��R�� pEp- �
���I�applloble�
1 �,�Gommittee.Infartl�a�Pn't����`�� �r�'` : �� ,:� :<. �y ,• . ,;i ...�r, �;2. T�J�y�; �p, � n (�`h p` n.. p q � f�.�
NAME OF COMMITTEE . �4Y��S..iE�ll�.oML!!PS�y,R�A+{�PT.�:,.,YQ�CE�S��i+i�':��`���C�'���..:.^uA�r.'��3�`�'.iS
NAMf �f TRFASUNEN
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STREfTRODRFS �NOPO.80%)
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Attach additional info�ma[ion on appropriately labeled conNnuation sheets.
3:T�en CdR10I1»'�7�tA.k`3�s'�dw�,� -r,a .� {�tiw::-ri���rs�b���.5e`*�T.id"t7�� .'9S^�P'+�5."�a_us.. �'r�t1- a -,. . �a' .'rn=n—�—+�:s=':cw��c,+r.�•cr,�at '�j�X
I have used all reasonable diligence in preparing[his statement and to the best of my knowledge the informatlon contained herein is true and complete. I tertify under
penalty of peryury under the laws of the State of California that the foregoing is true and correct. �
Executedon /� �]l.�(jl�o��� �(D�/7 By
�,A�, � 1 {� 51 NATUREOfiqEA511REROqP5515TPNTiPEA511qER
Enecutedan 1`�N��M 1✓. ��� BY
oar[
SIGNAiUPEOFt ROLIINGOfFlCENOLOfR,UN0IDATE,OqSTATFMEASIIpEVROPDNFNi
EKem[ed on gy
OATf SIGNRTORE OF CONTROIIING OFPCFHOIUEN,[�NDIOAiF,00.STRE MERSU0.E VROPONFNT .
E�eemted on gy
OAiE SIGNATURF Of CONTqOLLING OiqCEHOI�EP,CqND10AiF,Oq STRTE MEASORE PPOFONENT
FPPC Form 410(Jan/2016)
. FPPC Advice:advlce�,Dfppc.ca.gov(666/2753772)
www.fppc.w.gov
X
Statement of Organization � � o • '
ReC:pieni Committee • • � �
INiTRUCTIONS ON REVEFSE
Vage t
Ci:MM1M1It i°E�;4h1E v'_NUht?.P
�' V�� C � FCII� 1���� l�if�ll. C1+��0 , .
• All committees must Iist the Nnanoial institution where the campaign bank account Ic located.
R4IdE OF fiN4M1GaL INSTITUitOG :.iEA COLE/:l10Ni B=NH=.CC6U�T t�1fA9FP
A9�:i55 ❑T� STATE LPCJDE
a,.;�TYPe;ofCommlttee'��Gompleet the pa piic8f11B�52ClOW�d'���ni�y���EttNa+ *t �"tttd.�7���„�f��,�i''�9ii—'��5����i'a7r�Lm�r�{% `��'uW�����:�#�a�����u: 5x«.z���"�i, �r7,'(�2't
m111rllltl�lr W II�111��
• List the name of each controlling offiwholder,candidate,or state measure proponent. If candidate or officeholder concrolled,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 officehoider or candidate is affiliated or check"nonpartisan."
• If this committee acts joindy with another controlled committee, list the name and identlfication number of the other mntrolled committee.
EIfCDV'c OFFICE SOUGHT Oft HELO
NFME JF C4HDi�ATE/OPFlCcHOLDER/STATE MEASUNE CROFGNENT QNCLU�E DIiTRICT NUM1IBER IF APPLICABLEj YE4R OF ElER10N PdRTY
� Plonpartisan
PDAM A- R��� C1T`i o� TEnn�c��� CiN Cov�c�� 20�1�
� ❑ Nonpartlsan
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CFNDIJkT"ci5!PoaFI"c OR h1EASURE(i)f UCLTf7L'_�INQUDE 9AL!OT GO.OH iEl?E0.j
CA�¢OILATEIS)OFFICE SGUGHT OR PECD aft MEdSURE(SI lUAISDICTION
{INCLUDE DISTqiGT tJO.,QT''�R COVN iY,AS C4PlICaBLEj __��et3.
' SL'?FGc.i Goc-S� .
S:i>.CS� n>�>i5�
❑ ❑
FPPC Form 410(1an/2016)
FPPC Advice:advice@fppaca.gov(865/2753772)
�. www.fppc.ca.gov