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. � <br /> ., ,.. . .. <br /> Y <br /> Statement of Organization STATEMENTOFORGANI7ATIOM <br /> Recipient Committee • ' • . � <br /> e - <br /> INSTRUCTIONS ON REVERSE <br /> Page 2 <br /> COMMITTEE NAME I.O.NUMBER <br /> ClT\ZF].15 � O �O�-1.T1CAL — ��E � <br /> 4.Type of Committee Complete the applicable sedions. <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"non-partisan" <br /> • If this committee acts jointly with another wntrolled committee, list the name and identification number of the other controlled committee. <br /> NAME OF CANOIDATE/OFFICEHOLDEWSTATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD <br /> (INCLUDE DIS7RICT NUMBER IF APPUCABLE) � ��R OF ElECT10N PARTY <br /> � Non-Partisan <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 CODFJpHONE BANK ACCOUNT NUMBER <br /> ADDRESS CI7V STATE ZIP CODE <br /> -. Primarily formed to support or oppose specifc candidates or measures in a single election. List below: <br /> CANDIDATE(S)NAME OR MEASURE(S)FULLTITLE QNCLUDE BALLOT N0.OR LETTER) CANDIOATE(S)OFFICE SOUGHTOR HELD OR MEASURE(S)JURISDICTION <br /> QNCLUDE�ISTRICTNO.,CITVORCOUNTYASAPPLICABLE) CHECKONE � <br /> SIIPPOftT OPPOSE <br /> SUPPORT OPPOSE <br /> FPPC Form 410 (January/051 <br /> FPPC Toll-Free Helpline: 8661ASK-FPPC(866/27S377S1 <br />