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Statement of Organization , � . , <br /> Recipient Committee � . � � <br /> INSTRUCTIONS ON REVERSE <br /> Page 2 <br /> COMMI7TEE NAME <br /> I.�.NUMBER <br /> Cc. 1 �i�2.E "�"i! �12c� C�v� 1 L.� tr�►l`f�-- f'�E.t�, .. , �, Ct� ac�i <br /> • All committees must list the financial institution where the campaign bank account is located. <br /> NAME OF FINANQALINST�IUTION AREACOpE/PHONE BANKACCOUNTNUMBER <br /> t}�l` T�e� �M�r ,� � '� U �o�o � 2�� . `���t( C"y`/t3� rll � <br /> ADDftESS CITY STATE - ZIP CODE <br /> '7.i-i�� `1�r'c��idv,I�..;/ S�'r��-r �.� ��,-��. t L� '►Zedwr,��f c� ,-r�` . C�I ��fa�.� <br /> 4.Type of Comm�ttee Complete the applicable sect�ons. <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"nonpartisan" <br /> • If this committee acts jointly with another controlled committee,list the name and identification number of the other controlled committee. <br /> NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ��ECTIVE OFFICE SOUGHT OR HELD <br /> (INCLUDE DISTRICT NUMBER If APPLICABLE� YEAR Of ELECTION PARTY <br /> -` 0 Nonpartisan <br /> � � C�.� ,T� �-ECT GxG�C� L 1'T� �UU6r1�1 r ��� .� <br /> ❑ Nonpartisan <br /> ' �� � � -� • * Primarily formed to support or oppose specific candidates or measures in a single election. List below: <br /> CANDIDATE(5)NAME OR MEASURE�S)FULL TITLE(INCLUDE BALLOT N0.OR LETTER) CANDI�ATE(5)OFfICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION <br /> (INCLUDE DISTRICT NO.,QTY OR COUNTY,AS APPLICABIE) CHECK ONE <br /> SUPPORT OPPOSE <br /> ❑ ❑ <br /> SU�T O� <br /> FPPC Form 410(Dec/2012) <br /> fPPC Advice:advice@fppc.ca.gov(866/275-3772� <br /> www.fppc.p.gov <br />