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Staternent of Organization STATEMENTOFORGANIZATION <br /> Recipient Committee TYPe�'printinink P <br /> Date Stam <br /> . �. . <br /> I , <br /> Statement T e Initial �"' � <br /> YP ❑ [�J Amendment � Termination—See Part ������� orOfficial Use Only <br /> Not yet qualified Q or List I.D.number: List I.D.number: <br /> # �'?,� `i i cs�� # M�,Y 3 0 2013 <br /> —�—� �� a���L;_.� —J—� cirv�� ��n����t���rY <br /> Date qualified as commiriee Date qual�ed as committee Date of Termination <br /> �ff a�'��� CITY CLEeiK <br /> 1. Committee Information 2. Treasurer and Other Principal Officers <br /> NA1AE OF COMMITTEE f�� ,� �y,�{ ..r�� ��, ��er`Y" y=r NAME OF TREASURER <br /> — rt s� S c:.I'1 r�,� tz:l S` <br /> �r'vr' ���L�L+�'C i�1 t_ t� t= <br /> i..,�i; � �i.; � � �%��'t' �y;�`4 -3 i�=± `,.� , <br /> STREET ADDRESS <br /> STREET ADDRESS(NO P.O,BOX) ��� � ����`�+�� �t�CI��°��i �� % r�� Csft �/yQ�}_ <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> ��� - �t�t,,t,. .,� �._� t�� �Hc�-�, '�� � <br /> C� STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY <br /> , {�� • `?"TC1C. �/ C� LU �rL1 '''� <br /> MA!L.ING ADDRESS(IF DIFFEF2ENT) STREET ADDRESS <br /> .�` • <br /> � CITY STATE ZIP CODE AREA CODElPHONE <br /> OPTIONAL: FAX!E-MAIL ADDRESS <br /> �`��� r: 1 tt�[�' , ��} ��I �C 1 ►� �� ��� �,� <br /> NAME AND POSITION OF OTHER PRINCIFYIL OFFICER(5),IF APPLICABLE <br /> COUNTY OF pOMICILE COUNTY WHERE COMM�TTEE IS ACTIVE IF DIFFERENT <br /> THAN COUNTY OF DOMICILE <br /> MAILING ADDRESS <br /> ��TY STATE ZiP CODE AREA CODEIPHONE <br /> Attach additiona/information on appropriafelylabeled continuation sheets. <br /> 3. Verification <br /> I 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 penalty of <br /> pequry under the laws of the State of California that the foregoing is true and correct; <br /> ,, , � . <br /> F�c�utedon /�u / � '; • L t� �3 . _>�,J�., _' ' } <br /> �aTe � � �,�., ,` ' i,,.:;�,�t.•:� <br /> . � SIGN/PUR OF TREASURER OR ASSISTANT TREASURER <br /> EJ(�ll��Ofl __:�'1 �� Z � ' �-�t �i ... ,�� �, <br /> DATE � �� �SI fQNG U�tt oh c.uN t�LUNG OFFICEHOLDER,CANDID,4E,OR STATE MEASURE PROPONENT <br /> ExECUted on <br /> DATE � SIGNiVURE OF CONTROLLING OFFICEHOLDER,CANDID1dE,OR STATE MEASURE PROPONENT <br /> EX�Ilt�OCl � <br /> DATE SIGNATURE F CONTROLLING FFICEHOLDER.CANDIDFU'E,OR STATE MEASURE PROPONENT <br /> FPPC Form 410(Jan101) <br /> FPPC TeI1.Frea Helnline�8861ASK.FPPC <br />