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Statement of Organization <br />Recipient Committee STATEMENT OF~ lIZATION <br />INSTRUCTIONS ON REVERSE <br /> <br />COMr~ <br /> <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 /> district number, if any, and the year of the election. <br /> <br /> · List the political party with which each officeholder or candidate is affiliated or check "non-partisan., <br /> <br /> · If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. <br /> <br /> NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD <br />  ~ ~ ~ (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY <br /> <br /> ' isposition of surplus funds (controlled "candidate election" committees only) ,~.' <br /> NAMI~ OF FINANCIAL INSTITUTION <br /> <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) JURISDICTION <br /> ~" <br /> ·~P,~OSE <br /> FPPC Form 410 (8~99) <br /> For Technical Assistance: 916/322-5660 <br /> <br /> <br />