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Statement of Organization STATEMENT OF ORGANIZATION <br /> Recipient Committee � •- � , � <br /> •- <br /> INSTRUCTIONS ON REVERSE <br /> Page 2 <br /> COMMITTEE NAME I.D.NUMBER <br /> Elect Tania Sole <br /> 4.Type of Committee Complete the applicable sections. <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 /> distrid 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 /> NAME OF CANDIDATElOFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD <br /> (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY <br /> �� ' � Non-Partisan <br /> � G�v�c.� � °�t v�v`.e��,� 2tb1,S <br /> � Non-Partisan <br /> • List the financial institution where the campaign bank account is located(controlled"candidate election"committees only) <br /> NAME OF FINANCIAL INSTITUTION AREA CODElPHONE BANKACCOUNT NUMBER <br /> C� � �tQ�' f 7 � ��� <br /> ADDRESS CIN STATE ZIP CODE <br /> l 5tx� �c�cQ�.�Q� J <br /> . . 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) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISD�CTION <br /> (INCLUDE D�STRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECKONE <br /> SUPPORT OPPOSE <br /> SUPPORT OPPOSE <br /> FPPC Fortn 410(January/05} <br /> FPPC Toll-Free Helpline:866/ASK-FPPC(866/2�5-37T2) <br />