HomeMy WebLinkAboutKathy Smith - Form 410 - Termination - 01-27-2011m
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Statement of Organization
Recipient Committee
Statement Type ❑ Initial
Not yet qualified ❑ or
I I
Date qualified as committee
Type or print in ink
❑ Amendment
List I.D. number
Date qualified as committee
(If appligWe)
0 Termination —See Part 5
List I.D. number:
;3 /t /D
Date of Termination
NAME OF COMMITTEE
kad�(y S&A � CO av,�001t zoo o
STREET ADDRESS O P.O. BOX)
�4xov.eka Sf2ea�_ -X- 7S
ODE D�a, Buis 6bispa STATE
4 4j3W1 day' aVjS
(IF DIFFERENT)
OPTIONAL FAX /E- MAILADDRESS
COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFEREN I
V S /!� THAN COUNTY OF DOMICILE
C \l� Q � C�/L L/1y Y/l
Attach additional information on appropriately labeled continuation sheets.
CEIV'E®
JAN 2 8 2011
CITY CLERK
(NO P.O. BOX)
7 3. 754��ya
STATE
W s Ohl S-d) <:::;;L
STREETADDRESS (NO P.O. BOX)
STATEMENT OF ORGANIZATION
y8,
q01 T06-3-,V-6 Fro �
CITY STATE ZIP CODE AREA CODE /PHONE
NAME OF PRINCIPAL OFFICER(S)
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREACODE /PHONE
3. Verification
I have used all reasonable diligence in preparing this statement and to the best of my knowledge the
perjury under the laws of the State of California that the foregoing is true and corre
Executed on l J By
Executed on Z r>< 7 �I By
DATE slr.Nen
contained herein is true and complete. I certify under penalty of
Executed on By
PATE SIGNATURE OF CONTROLLING OFFlCEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGffATURE OF CONTROLLING OFFICEHOLDER, NDIDATE, OR STATE MEASURE PROPONENI
FPPC Form 410 1June/09)
FPPC Toll -Free Helpline: 866/ASK-FPPC 18661275 -3772)
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
STATEMENT OF ORGANIZATION
2
VVNIMII ICC IVNNC - -
,F�a 3a 976 S
4. Type of Committee Complete the applicable sections.
• 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 "non - partisan."
• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
r<
ELECTIVE OFFICE SOUGHT OR HELD
NAME OF CANDIDATE/OFFICEHOLDER /STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IFAPPLICABLE) YEAR OF ELECTION PARTY
�C Q 5rh y
• List the financial institution where the campaign bank account is located (controlled "candidate election" committees only)
NAME OF FINANCIAL INSTITUTION ARIA GUUt/HHUNt enrvrcAUUUUrvI Nurvmen
lLtlsS� a» C0JflMViLv,t 15alk 9&5-y92- Sabo /0,P-3,'53_,/
ADDRESS CITY STATE ZIPCODE
5 81 /47 j �
W4 Q SY, fA-J Z&is O&SPa CCU eF3 ye
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE S) NAME OR MEASURES FULL TITLE INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
( MEASURE( S) ( (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE
FPPC Form 410 (June/D9)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)
C�tj n VA1 i 1 /• LL TA-A_7
L7` rvon- Partisan
❑ Non - Partisan
• List the financial institution where the campaign bank account is located (controlled "candidate election" committees only)
NAME OF FINANCIAL INSTITUTION ARIA GUUt/HHUNt enrvrcAUUUUrvI Nurvmen
lLtlsS� a» C0JflMViLv,t 15alk 9&5-y92- Sabo /0,P-3,'53_,/
ADDRESS CITY STATE ZIPCODE
5 81 /47 j �
W4 Q SY, fA-J Z&is O&SPa CCU eF3 ye
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE S) NAME OR MEASURES FULL TITLE INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
( MEASURE( S) ( (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE
FPPC Form 410 (June/D9)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)