Laserfiche WebLink
Statement of Organization <br />Recipient Committee <br />INSTRUCTIONS ON REVERSE <br />COMMITTEE NAME <br />2', <br />• All committees must list the financial institution where the campaign bank account is located. <br />NAME OF FINANCIAL INSTITUTION AREACODE/PHONE BAINY, Al.001JNT NUMBER <br />AbOR��; ^ CY /006 STAT ZIP CODE / <br />List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled, <br />also list the elective office sought or held, and district number, if any, and the year of the election. <br />Page 2 <br />I.D. NUMBER <br />• List the political party with which each officeholder or candidate is affiliated or check "nonpartisan." Stating "No party preference" is acceptable <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 YEAR OF PARTY <br />NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE <br />Nonpartisan Partisan (list political party below) <br />Nonpartisan Partisan (list political party below) <br />Primarily formed to support or oppose specific candidates or measures in a single election. List below: <br />CANDIDATES) NAME OR MEASURES) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURES) JURISDICTION <br />IF A RECALL. STATE "RECALL" I N rRQNT OF THE OFFICEHOLDER'S NA M E. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE <br />�• <br />&U*7 a/SUPPORT <br />Ar a�d61 i <br />t� <br />OPPOSE <br />SUPPORT <br />OPPOSE <br />FPPC Form 410 (August/2018) <br />FPPC Advice: adviceWpric ayav_(866/275.3772) <br />www.f�—DC.CA&—OV <br />