HomeMy WebLinkAboutHarmon - Form 410 - 09-28-2022 TerminationFPPC Form 410 (F bruary/2018)FPPC Advice: advice@fppc.ca.gov (866/275-3772)www.fppc.ca.govStatement of OrganizationRecipient CommitteeCALIFORNIAFORM410SIgnATuRe OF COnTROllIng OFFICeHOlDeR, CAnDIDATe, OR STATe MeASuRe PROPOnenTSIgnATuRe OF COnTROllIng OFFICeHOlDeR, CAnDIDATe, OR STATe MeASuRe PROPOnenTDATeFor Official use Only1. Committee InformationI.D. Number (if applicable)3. VerificationDATeDATeDATeI 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 perjury under the laws of the State of California that the foregoing is true and correct.executed onexecuted onexecuted onexecuted onDate StampSIgnATuRe OF TReASuReR OR ASSISTAnT TReASuReRSIgnATuRe OF COnTROllIng OFFICeHOlDeR, CAnDIDATe, OR STATe MeASuRe PROPOnenTByByByByStatement Type Initial Not yet qualified or Date qualified as committee// Termination – See Part 5// Date of termination Amendment//Date qualified as committee2. Treasurer and Other Principal OfficersnAMe OF COMMITTeeSTReeT ADDReSS (nO P.O. BOx)CITy STATe zIP CODe AReA CODe/PHOneCOunTy OF DOMICIleJuRISDICTIOn WHeRe COMMITTee IS ACTIveMAIlIng ADDReSS (IF DIFFeRenT)nAMe OF TReASuReRnAMe OF ASSISTAnT TReASuReR, IF AnyAttach additional information on appropriately labeled continuation sheets.e-MAIl ADDReSS (RequIReD) / FAx (OPTIOnAl)CITy STATe zIP CODe AReA CODe/PHOneCITy STATe zIP CODe AReA CODe/PHOnenAMe OF PRInCIPAl OFFICeR(S)CITy STATe zIP CODe AReA CODe/PHOneSTReeT ADDReSS (nO P.O. BOx)STReeT ADDReSS (nO P.O. BOx)STReeT ADDReSS (nO P.O. BOx)e1388334X09 28 2022Heidi Harmon for Mayor 20201033 Stephanie DrSan Luis ObispoCA93405(805)550-8444heidiismighty@gmail.comTim Jouet674 SandercockSan Luis ObispoCA93401(805)546-10609/28/2022Tim Jouet9/28/2022Heidi HarmonE-Filed09/28/202217:24:53Filing ID:204860050
FPPC Advice: advice@fppc.ca.gov (866/275-3772)www.fppc.ca.govStatement of OrganizationRecipient CommitteeCALIFORNIAFORM410nAMe OF CAnDIDATe/OFFICeHOlDeR/STATe MeASuRe PROPOnenT• 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.4. Type of Committee Complete the applicable sections.COMMITTee nAMeI.D. nuMBeRPage 2InSTRuCTIOnS On ReveRSeControlled CommitteeCAnDIDATe(S) nAMe OR MeASuRe(S) Full TITle (InCluDe BAllOT nO. OR leTTeR)IF A ReCAll, STATe “ReCAll” In FROnT OF THe OFFICeHOlDeR’S nAMe.CAnDIDATe(S) OFFICe SOugHT OR HelD OR MeASuRe(S) JuRISDICTIOn(InCluDe DISTRICT nO., CITy OR COunTy, AS APPlICABle)Primarily Formed CommitteePrimarily formed to support or oppose specific candidates or measures in a single election. list below:eleCTIve OFFICe SOugHT OR HelD (InCluDe DISTRICT nuMBeR IF APPlICABle)SuPPORTPARTySuPPORTOPPOSeOPPOSeCHeCk OneCHeCk OneyeAR OF eleCTIOnnAMe OF FInAnCIAl InSTITuTIOnADDReSSSTATe zIP CODeCITy• All committees must list the financial institution where the campaign bank account is located.AReA CODe/PHOneBAnk ACCOunT nuMBeR nonpartisan P nonpartisanFPPC Form 410 (F bruary/2018)ePartisan (list political party below)artisan (list political party below)Page 2 of 3Heidi Harmon for Mayor 20201388334Heidi HarmonMayor: City of San Luis ObispoXUnion Bank(805)783-51400040332650995 Higuera StreetSan Luis ObispoCA93401
FPPC Advice: advice@fppc.ca.gov (866/275-3772)www.fppc.ca.govStatement of OrganizationRecipient CommitteeCALIFORNIAFORM410COMMITTee nAMeI.D. nuMBeRPage 3InSTRuCTIOnS On ReveRSe5. Termination Requirements• This committee has ceased to receive contributions and make expenditures;• 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.General Purpose Committeenot formed to support or oppose specific candidates or measures in a single election. Check only one box:PROvIDe BRIeF DeSCRIPTIOn OF ACTIvITylist additional sponsors on an attachment.nAMe OF SPOnSORSponsored CommitteeSTReeT ADDReSS nO. AnD STReeT CITy STATe zIP CODe AReA CODe/PHOneInDuSTRy gROuP OR AFFIlIATIOn OF SPOnSOR4. Type of Committee(Continued)By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that all of the following conditions have been met: CITY Committee COuNTY Committee STATe Committee Political Party/Central Committee // Date qualifiedSmall Contributor CommitteeFPPC Form 410 (F bruary/2018)ePage 3 of 3Heidi Harmon for Mayor 20201388334