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HomeMy WebLinkAboutCarlyn Christianson - Form 410 - Initial - 06-09-14Statement of Organization Recipient Committee Statement Type m Initial ❑ Amendment List I D number Nol yel qua6fed 0 o 11 Date quakhed as committee Dale qualified a5 Cunumttee III AnpLraLln 1 Committee I NAME OF COMMIT TEE ❑ Termination — See Part List I D nuinber Date of rerm6tation Carlyn Christianson for City Council 2014 STRCLI AOUNLSS INO TO TOM CIIV SIAII /IPCODI AIII A COM11'110111 San Luis Obispo CA 93401 ( TAX /L MAR AIIONESS COIINIYOI IIOMICKE AilesulClIull Will RI. COMMIIIII I IS ACIIVL San Luis Obispo I San Luis Obispo Attach addlnonal inJormohon an appropriately labeled connnuonon sheets 2. Treasurer and other NAME UI IRIASIIpEN Jeri Carroll SIIILLI AI)UNISSINOI'O IIIIXI I have used all reasonable diligence In preparing this st.dcmept a4rd to the best of illy k penalty of perjury under the laws of the State of all orma L tat tF/ roregomg Is t ti at' Executed on 61 ado /v ov All nAI[ f.NAIORt Or [UIIINOl11Tlti 01 Fl Ilse 51amp FO, Olhd Rl Use JUN 0 9 2014 CITY STATE ZIP 1.0111. All IA CLOT IN W N I. San Luis Obispo CA 93401 ( —MI Or A551SIANI IRr ASURIR 11 ANY 51111.11 AIJORCSSINU I'll IIOXI LIIV SIME III - 01)1)1 Alt IA C(1111 /VI ill AI NAME UI PRIKIPAI UI I I(m151 E 1.111111 I SS I NO PO COY SIAM I I ' l UUI Alit A 0001IPIIIIN I: correct the information contained herein Is true and complete I certify under, ASSISIANT Executed on OY UAII 51011.10X[ UT CUIII ROI LING OI I ICI 110 IILN (All aI OAT (, OR 51.1E MrASUXI 1'XUI'UIILN I rXecuted 011 By MAII: SIGNAl111R OF rn11111(11IING UTI ICIIIOI aril CANUIDAII 01151.11'. Mt 'A511111 PXn 1'11111 NI fPPC Form 410 (Dec /2012) FPPC Advice advice @fppc ca gov (866/275.3772) www fppc ca gov Statement of Organization Recipient Committee INSTRUCTIONS ON RCVER5L. COMMIT ll r NAMI: Carlvn Christianson for City Council 2014 • All committees must list the financial Institution where the campaign bank account is located NAME OF FINANCIAL INSHIUIIDN arrount not opened yet ADONLSS Complete the applicable sections Cllr S1AII ZIP CODE O NNMRnI • List the name of each controlling officeholder, candidate, or state measure proponent If candidate or olhceholder controlled, also list the elective office sought or held, and district number, If any, and the year of the election • List the pohhcal party with which each officeholder or Candidate Is affiliated or check "nonpartisan " If this committee acts jointly with another controlled committee, list the name and Identification number of the other controlled committee ELECTIVE! orFICE SO Urill IT OR FIELD .............,... ..... ,...�......nr..r on.... Dun Tim FIKTRIH I NUMOCR IF APPLICAIII.III YLAR 01' ELECTION PARTY NAM, UI l/•rvuiuni.. /.,rrivay......n _...._......._..__..._ _ SUPPORT El _ m Nnn {tarltsan Carlyn Christianson Council Member, City of San Luis Obispo 2014 poJ./I�S ❑ NanparUSalt Primarily formed to support or oppose specific candidates or measures in a single election List below CANDIDAI'E(S) Oi FICL SOIIGNT OR IILLO OIL MEASURE(S) IURISDiC I ION _..__._ ._...._ ........................ u.. ,.nin.,cm ...._....... n... a.r.un ruvnornuuly A<APPIIrARIEI nm.vnm FPPC Form 430 (Dec/2012) FPPC Advice advice @fppc ca gov (866 /275 -3772) www fppc ca gov SUPPORT El OPI OSE EL SL I'llI poJ./I�S FPPC Form 430 (Dec/2012) FPPC Advice advice @fppc ca gov (866 /275 -3772) www fppc ca gov Statement of Organization Recipient Committee INS I RUC i IONS ON REVERSE Carlyn Christianson for City Council 2014 4. Type of Committee jeonnnued) Not formed to support or oppose specific candidates or measures in a single election Check only one box ❑ CITY Committee ❑ COUNTY Committee STATE Committee ❑ESCRIPI ION 01 List additional sponsors on an attachment NAME OP 11-005011 SI ITT C; MNtl175S NO ANO CITY Iry 4xuuP OR An ILIA 11011 or SPONSOA 1• ❑ / ---/ LIIO Yllilllled 5.Termin nRequirements Bystgninglhever lhaihon, (lie lreasurer, assislani treasurer a TWO, candldate, officehoide.r, ofproponentmrtifythatatI oft lie followtigcondItionshave been nieP • This committee has ceased to receive conk Ibutions and make expenditures, • This committee does not anticipate receiving contributions or mal king 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 • Phis 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 185215 FPPC Form 410 (Dec /2012) FPPC Advice adviceftric ca gov (866/275.3772) www fppc.ca gov qo Statement of Organization Recipient Committee Statement Type © Initial Not yet qualified ® or �3��ys3 ❑ Amendment List I.D. number: Date qualified as committee Date qualified as committee (If appfica ble) ❑ Termination — See Part 5 List LID number: Date of Termination 1. Committee Information NAME OF COMMITTEE Carlyn Christianson for City Council 2014 STREET ADDRESS (NO P.O BOX) 1415 Morro St., #16 CITY STATE ZIP CODE AREA CODE /PHONE San Luis Obispo CA 93401 (805)550 -9320 MAILING ADDRESS (IF DIFFERENT) FAX / E -MAIL ADDRESS COUNTY OF DOMICILE I JURISDICTION WHERE COMMITTEE IS ACTIVE San Luis Obispo San Luis Obispo Attach additional information on appropriately labeled continuation sheets. Date Stamp CEIVED AND FIL in a office f tte State of Camornt of a JUN 12 2014 DEBRA BOWEN Secretary of Stat( For Official Use Only JUN 25 2014 2. Treasurer and Other Principal Officers NAME OF TREASURER Jeri Carroll STREET ADDRESS (NO P.O. BOX) 2493 Lawton Ave. CITY STATE ZIP CODE AREA CODE /PHONE San Luis Obispo CA 93401 (805)543 -6156 NAME OF ASSISIANT TREASURER, IF ANY STREET ADDRESS (NO P.O. 110* CITY STATE ZIP CODE AREA CODE /PHONE NAME OF PRINCIPAL OF FICER(S) STREET ADDRESS (NO P O BOX) CI rY STATE ZIP CODE AREA CODE /PHONE Verification f I have used all reasonable diligence in preparing this statemerft a?t�cJ 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 4fasnia that tFp foregoing I�t a and correct. Executed on 7 �a�j/ y Byj //! f11 ATE NATURE OF TREASURER OR ASSISTANT TREASURER Executed on LT By r r DATE . GNATURE OF CONTROLLING 01`1`IC11417LDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By _ DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE of fo NTRQLLING OFFWtHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410(Dec/2012) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME 1 0. NUMBER Carlyn Christianson for City Council 2014 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION account not opened yet ADDRESS 4. Type of Committee Complete the applicable sections. CITY BANK ACCOUNT NUMBER STATE ZIP CODE • 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" • 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 Carlyn Christianson ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF .APPLICABLE) YEAR OF ELECTION Council Member, City of San Luis Obispo 12014 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) PARTY 0 Nonpartisan Nonpartisan CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECKONE SUPPORT I OPPO5E SUP a T 1 dF] FPPC Form 410 (Dec /2012) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Statement of Organization CALIFORIIIA Recipient Committee INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME LID NUMBER Carlyn Christianson for City Council 2014 4. Type of Committee (Continued) 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. NAME OF SPONSOR I STAY GROUP OR AFFILIATION 01- SPONSOR STREET ADDRESS NO AND SI PEET CITY STATE ZIP CODE Small Contributor Committee Dalc qualified 5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and /or candidate, officeholder, or proponent certify that all of the following conditions have been met: • 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. FPPC Form 410(Dec /2012) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc- ca.gov