HomeMy WebLinkAboutDrake - Form 410_2024-04-01_Received by SOS_RedactedStatement of Organization (a
R CElVE6tM FIL
Recipient Committee,?C
in t e office of the Secretary of f
Statement T of the State of California
Type nitial ❑Amendment ❑Termination —See Part 5
Not yet qualified FEB 12 2024
or
0 Date qualification threshold met Date qualification threshold met Date of termination
e e e I.D. Number e e
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NAME OF COMMITTEE NAME OF TREASURER
�K-b FOR SCO CiiY CO"ClL 202-q
STREET ADDRESS INO P.O. BOX) CITY
CITY STATE ZIPCODE AREACODE/PHONE
somu4ij 01oloi oS
FULL MAILING ADDRESS (I F DIFf RENT)
E-MAIL ADDRESS OF COMMITTEE (REQUIP.FD) / FAX (OPTIONAL) , �NK C
IC-'71 1 itil.-A c Ln 1 .t,t i t IN, I
Attach additional information on appropriately labeled continuation sheets.
ENT AIL AD DRESS -)F TRFASURFR (RFQUIRED)
ME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
EMAIL ADDRESS OF ASSISTANT TREASURER
CITY
For Official Use only
9%
STATE ZIP CODE
GA q3etc
AREA CODE/PHONE
AREA CODE/PHONE
STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE
EMAIL ADDRESS OF PRINCIPAL OFFICER(S) (REQUIRED) AREACODE/PHONE
I have used all reasonable diligence in preparing thi state t and t the best of my knowledge the information contained herein is true and complete. I certify under
penalty of perjury under the laws of the S g is true and correct.
Executed on / I ZU 2-4 By $ PEf�; ! tt
TE SIGNATURE OF TREASURER OR ASSISTANT TREASURER $
Executed on ' By r a a 20211 $
OATS TROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT I �+ n �-st7 L S '
Executed on By II14 SLO 'J"' - t1 Gr) '3'
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (October/2023)
FPPC Advice: advice@fppc.ca.¢ov (866/275-3772)
www.fooc.ca.eov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME 7I LJ. NJM198CR
ye
• All committees must list the financial institution where the campaign bank account is located and the person(s) authorized to obtain bank records.
NAME OF FINANCIAL INSTITUTION Al PERSON(SI AUTHORIZED TO OBTAIN BANK RECORDS 11 AREA CODE/PHONE I BANK ACCOUNT NUMBER
ADDRESS OF FINANCIAL INSTITUTION
CITY STATE 71P CODF
• 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.
ELECTIVF OFFICE SOUGHT OR HE[ D YEAR OF PARTY
NAME OF CANDIDATE/OFFICEHOLDFR/STATE MEASURE PROPONENT IINn line nlcrairr wino ono .� A - �I
-
Nonpartisan
Nonpartisan
Partsan
Partisan
(I st political party below)
(list political party below)
Primarily Formed Commirtee Primarily formed to support or oppose specific/ candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURF(S) FULL TIT[ F (INCLUDE BALLOT NO OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HFI D OR MEASURE(S) JURISDICTION
IF A RECALL, STATE "RECALL" IN FRON r OF THE OFFICEHOLDI'l Nnnnr
. . ---- -._..._. .. ..... �. ..., .... .,........,..
CHECK
�LPPOF-
ONE
FPPC Form 410 (October/2023)
FPPC Advice: advice _fppc.ca.eov_(866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSF
LO
CommitteeGeneral Purpose 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
• • List additional sponsors on an attachment.
STREET ADDRESS
"Ll. ANL)JI KttI
Smaii Contributor Committee
CITY
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
• This committee has ceased to receive contributions and make expenditures;
Page 3
I.D. NUMBE
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 Sec -ion 18G80 and FPPC Regulation 18S21.5.
FPPC Form 410 (October/2023)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fp c.ca. ov