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���t�C�l�F�� �� Orgafll���l0� STATEMENT OF ORGANIZATION <br /> ���i������ ������tte� . � . � ' <br /> . - <br /> INSTRUCTIONS ON REVERSE <br /> Page 2 <br /> COMMITTEE NAME <br /> I.D.NUMBER <br /> D <br /> i--i% .Yl dVl i ��-��... '�C� t%..i F t (._:: r��t `a-' 1 �r� �r" .i-c:.'" l�e t,�i.�✓.-.�:�l � r-.� i.�e:.,,:Y�;�, 1 7 c�: � ..� `:a `7 I v'_i <br /> '4•�'�p��f Committee Complete the applicable sections. <br /> . . •. . <br /> � List the name of each controlling officehoider,candidate,or state measure proponent. If candidate or officehoider controlled,also list the elective office sought or held,and <br /> district number, if any, and the year of the election. <br /> m 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 controlied committee. <br /> NAME OF CANDIDFVE/CFFICEHO�DERlSTATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD <br /> (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PAR TY <br /> Q Non-Partisan <br /> �- - r1 i� `�L.!�; ,v� a C'� T' . ,. ,; ._� <br /> il��-��,,;LFt•f•i � ,�,-. � �,c.��,�, � 1 Z�';, <br /> � Non-Partisan <br /> a Listthe financial instituiion where the campaign bank account is located(controlled"candidate election"committees only) <br /> NAME OF FINANCIAL INSTITUTION AREA CODEiPHONE BANK ACCOUNT NUMBER <br /> �� r 7'� 1 ' !' C�v. r%i v 1: rL.`>r� L�l r-s --� �' 1 � U�.�'�/i_i� I/� .? <br /> ADDRESS CITY STATE ZIP CODE <br /> � -� � yj�i'L r^ _ <br /> �.% c.� - .� <br /> i r. �:a,� "��:_�..�I �� i"+L...LT a.,. 1` -'t, /i: L.: r�!-�f�.v::";i� L.. i�T'--�' ( ,C� i .. <br /> } <br /> • -� •*� Primarily formed to support or oppose specific candidates or measures in a single eleciion.�ist below: <br /> CANDIDATE(S)MAME OR MEASURE(S)FULL TITLE pNCLUDE BALI.OT NO.OR LE(TER) CANDIUATE(S)OFFICE SGUGHT OR HELD OR MEASURE(S)JURISDICTION <br /> (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK oNE <br /> SUPPORT OPPOSE <br /> SUPPORT OPPOSE <br /> FPPC Form 410(Jan/01} <br /> FPPC Toli-Free Helpline:866(ASK-FPPC <br />