Laserfiche WebLink
Statement of Organization • • - �� • � <br /> Recipient Committee • - � '� <br /> INSTRUCTIONS ON REVERSE <br /> Page 2 <br /> COM ITTEE NAME I.D.NUMBER <br /> 2 4 \�- �.�1 ;, �Dv�^ ` ` f7�� <br /> • All committees must list the financial institution where the campaign bank account is located. <br /> NAME Of FINANCIALINSTITUTION AftEACODE/PHONE BANKACCOUNTNUMBER <br /> Q • � fo�� - $ ' �, D o l3� - <br /> ADDRE55 CITY STATE ZIP CODE <br /> � <br /> �— �� T p vJ Q.. Oc�� C—� C� � `�D(�3 <br /> . �� , <br /> . . .. . � .. _ <br /> • 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 <br /> district number,if any,and the year of the election. <br /> • List the political party with which each officeholder or candidate is affiliated or check"nonpartisan." <br /> • If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. <br /> ELECTIVE OfFICE SOUGHT OR HELD <br /> NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER If APPIICABLE) YEAR OF ELECTION PARTY <br /> + ��� �� Nonpartisan <br /> �� � C` �-� � �.ol s <br /> ❑ Nonpartisan <br /> � � •� � Primarily formed to support or oppose specific candidates or measures in a single election. List below: <br /> CANDIDATE�S)NAME OR MEASURE(5)FULL TITLE(INCLUDE BALIOT N0.OR LETTER) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION <br /> (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) cHECK oNE <br /> SUPPORT OPPOSE <br /> ❑ ❑ <br /> SU�T OPPOSE <br /> ❑ <br /> FPPC form 410(Dec/2012) <br /> FPPC Advice:advice@fppc.ca.gov(866/275-3772) <br /> www.fppc.ca.gov <br />