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Statement of Organization STATEMENT OF ORGANIZATION <br />Recipient Committee ALIFORNIA <br />INSTRUCTIONS ON REVERSE <br />Page 2 FORm 410 <br />COMMITTEE NAMEI.D. NUMBER <br />4. Type of Committee Complete the applicable sections. <br />■�lan� u� I l�.�eiaiuui}��:a� <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/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY <br />n Non -Partisan <br />• List the 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 />0QJ1ui-111llAlauua0 Mi}uaa Primarily formed to support or oppose specific candidates or measures in a single election. List below: <br />CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) <br />Non -Partisan <br />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: 866/ASK-FPPC (866/275-3772) <br />