HomeMy WebLinkAboutSpecht - Form 410 - 2022-08-12_RedactedStatement of Organization
Recipient Committee
Statement Type ❑ Initial ❑ Amendment
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•WiI.D. Number
NAME OF COMMITTEE
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1 S IATE ZIP CODE AREA C(
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SFULL MAILING ADDRESS (IF DIFFER
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E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL)
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COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
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Attach additional information on appropriately labeled continuation sheets.
penalty of perjury under the laws of the S
1 o Executed on z By
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Executed on ( 2-v)2— g
DATE y
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Termination — See Part
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Date of termination
Date Stamp
RECEIVED
-4 UG I 2022
SL CLERK
NAME OF TREASURER
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NAME OF ASSISTANT TREASURER, IF ANY
STREETAD0RESS (NO P.O. BOX)
CITY
NAME OF PRINCIPAL OFFICER(S)
For Official Use Only
ZIP CODE AREA CODE/PHONE
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ZIP CODE
STAT£ ZIP CODE AREA CODE/PHONE
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to the best of my knowledge the information contained herein is true and cnm
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Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (August/2018)
FPPC Advice: advice a&fooc.ca.¢ov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
IITTEE NAME
CkVCV F-�r
All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
ADDRESS
AREA CODE/PHONE I BANK ACCOUNT NUMBER
CITY STATE ZIP CODE
Page 2
I.D. NUMBER
Controlled Committee
• 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 YEAR OF PARTY
(INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
��-^��-'.%.�}�y u. 101� Nonpartisan
1 3 l _ 1 1 � f 1 I■ 1 l��r \ Y/� �f1 1 I Y Y 1 %�% fi%!`.1 r+ � r r__ �
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)
iS
n (list political party b
n (list political party b
CHECK ONE
SUPPORT
OPPOSE
SUPPORT
OPPOSE
FPPC Form 410 (August/2018)
FPPC Advice: advice0Dfppc.ca.¢ov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME Page 3
I.D. NUMBER
General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
CITY Committee ❑ COUNTY Committee
❑ STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
SponsoredList additional sponsors on an attachment:
NAME OF SPONSOR
NU.ANUSIKEE1
CITY
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
• This committee has ceased to receive contributions and make expenditures;
STATE ZIP CODE AREA CODE/PHONE
• This committee does not anticipate receiving contributions or making expenditures in the future;
• This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations;
• This committee has no surplus funds; and
• This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions.
— There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to
Government Code Section 89519.
— Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511-
89518, and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5.
FPPC Form 410 (August/2018)
FPPC Advice: advice a0fooc.ca.gov (866/275-3772)
www.fppc.ca.gov