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Statement of Organization STATEMENT OF ORGANIZATION <br /> Recipient Committee . .. . � t <br /> . - <br /> INSTRUCTIONS ON REVERSE <br /> Page 2 <br /> COMMiTTEE NAME <br /> I.O.NUMBER <br /> �G���M t T-�.�- �u i?i E C' �` °� �`� S '1 »'i ,_ r-- .l-c'.� l'err�y��,::'1 �'- :r- � Cc-�•�v�Ci d Z.�; :3 � .� � 1 l �%! <br /> 4.Type af Committee Completetheapplicabiesections. <br /> . . -. . <br /> • List the name of each controlling officeholder,candidate,or state measure proponent. If candidate or officeholder controfled,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 /> e If this committee acts jointly with another controlied committee,list the name and identification number of the other controlled committee. <br /> NAME OF CANDIDFYElOFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HE�D <br /> (INCLUDE DISTRICT NUMBER IF APPUCABLE) YEAR OF ELECTION PARTY <br /> � �� ' � Q Non-Partisan <br /> �i.�'� �v� � C� � 1 �c"�t`�V"t"t°t'� C � -r-� L(1 E�'�l C:. ,' � Z-c'n i� <br /> �Non-Partisan <br /> • List the financial institution where the campaign bank account is located(controlled"candidate election"committees only) <br /> NAME OF FINANC�AL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER <br /> V� a � ' c,r. ta ►t (c�c� 2.9°, Z r � B U�l�l�'i C' I%/� <br /> ADDRESS �TY STATE ZIP CODE <br /> •���� !� ~�'���Y�+�L�l -��3 �.L,� �� T� i L��Lr tj�-�rl LrVL44� L.� ��T`/ � �J 7 /�� � <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 8ALL0T NO.OR IETiER) CANDIDATE(S)OFFICE SOUGHT OR HEID OR MEASURE(S)JURISDICTION <br /> (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPUCABLE) cHECK ONE <br /> SUPPORT OPPOSE <br /> SUPPORT OPPOSE <br /> FPPG Form 410(Jan/01) <br /> FPPC Toll-Free Helpline:866/ASK-FPPC <br />