HomeMy WebLinkAboutHarmon - Form 410 - 07-31-2020Statement of Organization
Date Stamp ,
Recipient Committee
'F.',Official
Statement Type Q•Initial ❑ Amendment ❑ Termination - See Part 5
RECEIVED
Use Only
a Not yet qualified
Of
J U L 3 1 2020
a Date qualification threshold met Date qualification threshold met
Date of termination
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• I.D. Number
2. Treasurer and Other
Principal Officers
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NAME OF COMMITTEE
NAME OF TREASURER
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TE ZIP CODE (AREA CODE/PHONE
CITY 1` a -A
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NAME OF ASSISTANT TREASURER, IF ANY
FULL MAILING ADDRESS (IF DIFFERENT)
STREET ADDRESS (NO P.O. BOX)
E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL)
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CITY
STATE ZIP CODE
AREA CODE/PHONE
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COUNTY OF DOMICILE
JURISDICTION WHERE COMMITTEE IS ACTIVE
NAME OF PRINCIPAL OFFICER(S)
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STREET ADDRESS (NO P.O. BOX)
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CITY
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Attach additional information on appropriately labeled continuation sheets.
3. Verification
have used all reasona e i igence in preparing this statement and to Me —best of my knowledge the information containecl herein is true and complete. I certify under
penalty of perjury under the laws of the State of
PROPONENT
FPPC Form 410 (August/2018)
FPPC Advice: advice(866/275-3772)
WW .fPPS Cd,guv
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
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• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
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ADDRESS
AREA CODE/PHONE
CITY
Page 2
I.D. NUMBER
BANK ACCOUNT NUMBER
ZIP CODE
List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled,
also list the elective office sought or held, and district number, if any, and the year of the election.
• List the political party with which each officeholder or candidate is affiliated or check "nonpartisan." Stating "No party preference" is acceptable
• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE)
YEAR OF
ELECTION
PARTY
CHECK ONE
Primarily Formed Commiffee Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME, (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
FPPC Form 410 (August/2018)
FPPC Advice: advice f c. god-(866/275-3772)
www.fppc.C9.g0v