HomeMy WebLinkAboutSpecht - Form 410 - 2022-09-23_RedactedLl11
O Termination -See Part 5
Statement of Organization
Recipient Committee
Statement Type l..-&f'----,~-it-ia-, --------.-1--------~I ------------11 O Amendment
{9"Not yet qualified
• I or O Date qualification threshold met I Date qualification threshold met Date of termination
RE CEIV ED
SEP 2 3 2022
S LO CITY CLERK
CALIFORNIA 41 0
FORM
For Official Use Only
--1 1--
NAME OF COMMITTEE
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ST
CITY ZIP CODE AREA CO DE/PHONE
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E-MAIL ADDRESS (REQUIRED)/ FAX (OPTIONAL)
S-e.--'2 i ~ o-e ~-\-<os (b' ~ -(V"\o.. \ \ -· ~O),'Yl
JURISDICTION WHERE COM M ITTEE IS ACTI VE
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Attach additional information on appropriately labeled continuation sheets.
f Executed on
O Executed on
DAT!:
Executed on By
NAME OF TREASURER
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CITY
+
NAME OF ASSISTANT TREASURER , IF ANY
STREET ADDRESS (NO P.O . BOX)
CITY
STREET ADDRESS (NO P.O. BOX)
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE , OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER , CANDIDATE, OR STATE MEASURE PROPONENT
STATE ZIP CODE AREA CODE/PHONE
STATE ZI P CO DE A!lEA CODE/PHONE
STATE ZIP CODE AREA CODE/PHONE
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca .gov (866/275-3772)
www.fppc.ca.gov
I
Statement of Organization
Recipient Committee
CALIFORNIA 41 Q
FORM
INSTRUCTIONS ON REVERSE
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• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
S'6S 5'-f J o <-{CO .s\O~ flj
ADDRESS
5CO f'Mrsh S'f. Cl~A-STATE ZIP CODE
IOI .O .U.tiJ.1..1.. ii!;;
Controlled Committee
List the name of eac h controll ing officeholder, candidate, or state measure proponent. If ca ndida te or officeholder controlled,
also list the el ective office sou ght or held, and district number, if any, and the year of the ele ction.
Page 2
1.D. NUMBER
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 DIST-1\.l~T NUMBER IF APPLICABLE)
YEAR OF
ELECTION
PARTY
CHECK ONE
Nonpartisan Partisan
I
(list political party below) ...
Nonpartisan Partisan {list political party below) • "'
Primarily Formed Committee 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 DISTRKT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE I ----------I------------l so,,,., l ,,.,.. I
Se G4'erj (hn l:e, J Sf -eth t -: '!fA4 'J a,.. -,lk, ~' s a\, e, ~· '""'"' """ ~
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275·3772)
www.fppc.ca.gov