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Statement of Organization DateStamp , � . , <br /> Recipient Committee • ' <br /> Statement Type Q Initial ❑ Amendment ❑ Termination—See Part 5 � ' s � <br /> Not yet qualified � or List I.D.number: List I.D.number: <br /> # # <br /> aPR o 5 2013 <br /> � � / / / / CITY OF FFEp1/VOpD C1TY <br /> Date qualified as committee Date qualified as committee Date of Termination <br /> (If applicable) C�TY CLERK <br /> 1.. ��mE������ � { " �. "�.�r��a��r Pr�cip�����s ; <br /> NAMEOF�COMMITTEE`o��� TQ,Q�� �'U `4i.P�G��� 6��-���� jC,`�pVAaO�'r NAME Of TREASURER <br /> ���i" iZ EE C�l�t��`1 C. :'r�/ G a i;r.c : � Z Ca 1 � t r2�^, t°S ��A � . !�3 C'� °\ � � <br /> STREET ADDRE55(NO F.O.BOX) STftEET ADDRE55(NO 0.0.BOX) <br /> ' . �edwoec� C � -�✓, C.� gyo62 2eclw�rc� C � T�/. C.a 9UU6Z <br /> ❑TY STATE ZIP CODE AREA CODE/PHONE ❑TY STATE ZIP COOE AREA CODE/PHONE <br /> MAILING ADDRESS(IF�IFFERENT) NAME OF ASSISTANT TREASURER,�f ANY <br /> FAX/E-MAIL ADDRE55 STREET ADDRESS�NO P,O.60X) <br /> � <br /> COUNTY OF DOMICILE lURISDICTION W4ERE COMMITTEE IS ACTIVE QTY STATE ZIP CODE AREA CODE/PH�NE <br /> 3 <br /> _,l�Y� /Vl A 1 <br /> � NAME OF PRINCIPALOFfIGER�S) <br /> STREET ADDRE55(NO P O.BOX) <br /> Attach additional information on appropriately labeled continuation sheets. <br /> CITY STATE ZIP CODE AREA CODE(PHONE <br /> `;j �` � _ ; , � , _"'?- -``; - .' s ;. _ '�_ <br /> � 1 have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under <br /> penalty of perjury under the laws of the State of California that the foregoing is true and correct. <br /> Executed on i�a r i � �r �O 1 3 By �o.�-�J�� <br /> DATE SIGNATURE FT ASURERORASSISTANTTREASUREft <br /> Executed on (a�r� � �� � �3 By � �' ��+�(Ei'►!J <br /> DATE � SIGNATUREOFCONTROLL-IN�I�HaLDER,CANDIDATE,OR5TA7EMEASUREPROPONENT <br /> Executed on By <br /> �ATE SIGNATURE OF CONTROLLING OFFILEHOLDER,CANDI�ATE,OR STATE MEASURE PROPONENT <br /> Executed on By <br /> DATE SIGNATURE OP CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT <br /> FPPC Form 410(Dec/2012) <br /> FPPC Advice:advice@fppc.ca.gov(866/275-3772) <br /> www.fppc.ca.gov <br />