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Statement of Organization STATEMENT OF ORGANI7ATION <br /> Recipient Committee � � � � <br /> . - <br /> INSTRUCTIONS ON REVERSE Paga P <br /> I.D.NUMBER <br /> COMMI�s� E � � � �� <br /> /lA°U� �, <br /> NN <br /> 4.Type of Committee Compleletheapplicablesections. <br /> . <br /> . List the name of each controlling officeho�der,candidate,or state measure proponent. If candidate or oificeholder controlled,also list the eledive o�ce 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 /> NAMEOFCANDID�YE/OFFICEHOLDER/STATEMEASUREPROPONENT (INCLUDEDISTRICTNUMBERIFAPPLICABLE) YEAROFELECTION PARTY <br /> �NorrPartisan <br /> RvsqN•vF �-aasr G C�su,r�+,c- Gr oF �wo� C�r �3 <br /> �Non-ParGSan <br /> • Listthefinancialinstitutionwherethecampaignbankaccountislocated(controlled"candidateelection"commiHeesonly) <br /> NAME OF FINANCIALINSTITUTION AREACODE/PHONE BANK ACCOUNT NUMBER <br /> ����vr9 �iiG/� 5� 3� //o�� 06/22ac7/ <br /> AODRESS CITV. STATE ZIP CODE <br /> 9oD 1l��°�2�15 .B�dP r��r.va�� �T� ��- 9¢D�3 <br /> Primarilyfortnedtosupportoropposespecificcandidatesormeasuresinasingleelection.Listbelow: <br /> CANDIDATE(5)NAME OR MEASURE(S)FULL TITLE INCLUDE BALLOT NO.OR IETTER) CANDIDATE(S)OFFICE SOUGHT OR HELO OR MEASURE(S)JURISDICTION <br /> ( (INCLUDEDISTRICTNO.,CITVORCOUN7Y,ASAPPLICABLE) CHECNONE <br /> SUPPORT OPPOSE <br /> SUPPORT OVPOSE <br /> FPPC Form 410(Janl01) <br /> FPPC Toll-Free Helpline:B661ASK-FPPC <br />