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Statement of Organization <br />Recipient Committee <br />INSTRUCTIONS ON REVERSE <br />COMMITTEE NAME <br />STATEMENT OF ORGANIZATION <br />CALIFORNIA <br />FORM <br />1 <br />Page 2 <br />�� v,�_ �� � / �Q • t y ,C/� I.D. NUMBER <br />—A. -a <br />4. Type of Committee Complete the applicable sections. " <br />iA•„iu•�lla•r.eta uun tr�x:� <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 'non-partisan." <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/OFFICEHOLDERISTATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY <br />Non-Partlsan <br />• Listthe financial institution where the campaign bank account is located (controlled "candidate election" committees only) <br />NAME OF FINANCIAL INSTITUTION <br />ADDRESS <br />AREA CODE/PHONE <br />CITY <br />BANK ACCOUNT NUMBER <br />STATE ZIP CODE <br />❑ Non -Partisan <br />•:.I.•i:i,lri3.�,•a�.ket•Ln,f,Fa� Primarily formed to support or appose specific candidates or measures in a single election. List below: <br />CANDIDATE(5) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. 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 />SUPPORT OPPOSE <br />FPPC Form 410 (January/05) <br />FPPC Toll -Free Helpline: 66B/ASK-FPPC (86612753772) <br />