HomeMy WebLinkAboutPaul Brown - Form 410 - Termination - 07-31-2013Statement of Organization
Recipient Committee
Statement Type ❑ Initial
Not yet qualified ❑ or
Date qualified as committee
1. Committee Information
Type or print In Ink
❑ Amendment
List I.D. number:
Date qualified as committee
(If applicable)
® Termination — See Part 5
List I.D. number:
# 1355992
07 l- 311 / 2013
Date of Termination
NAt1E OF COMMITTEE
Poul Brown SLO City Council 2013
STPEETADDRESS (NO P.O. BOX)
CI7y STATE ZIP CODE AREA CODE/PHONE
San Luis Obispo CA 93405
MPILING ADDRESS (IF DIFFERENT)
oPrIONAL: FAX/ E -MAIL ADDRESS
COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE
Sin Luis Obispo
Attich additional information on appropriately labeled continuation sheets.
Date Stamp
JUL 3 4 2013 tp
2. Treasurer and Other Principal Officers
NAME OF TREASURER
Lauren Fogle
STREET ADDRESS
STATEMENT OF ORGANIZATION
ForOHiclal Use Only
CITY STATE ZIP CODE
AREA CODE /PHONE
San Luis Obispo CA 93401
NAME OF ASSISTANT TREASURER, IF ANY
Paul Brown
STREET ADDRESS
CITY STATE ZIP CODE
AREA CODE /PHONE
San Luis Obispo CA 93405
NAME AND POSITION OF OTHER PRINCIPALOFFICER(S), IF APPLICABLE
Dan Hinz, Committee Co -Chair / Michelle Tasseff, Committee
Co -Chair
93405 / 93401
CITY STATE ZIP CODE AREA CODE /PHONE
San Luis Obispo CA
3. Verification
I love 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
pejury under the laws of the State of California that the foregoing is true and correct.
E,acuted on 07/31/2013
DATE
„n 07/31/2013
DATE
6Acuted on
DATE
EAcuted on
DATE
By
SIGNATURE OFTR ASSISTANT TREASURER
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE
FPPC Form 410 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
STATEMENT OF
COMMITTEE NAME LD..NUMBER
Paul Brown SLO City Council 2013 11355992
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.
OR
NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT AP HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
Paul Brown
San Luis Obispo City Council Member
2013
N Non - Partisan
BANK ACCOUNT NUMBER
Coast National Bank
Q Non - Partisan
• List the financial institution where the campaign bank account is located (controlled "candidate election" committees only)
NAME OF FINANCIAL INSTITUTION
AREA CODE /PHONE
BANK ACCOUNT NUMBER
Coast National Bank
ADDRESS
CITY
STATE ZIP CODE
San Luis Obispo
CA 93401
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
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK
SUPPORT
SUPPORT
FPPC Form 410 (January /05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275.3772)
Statement of Organization
Recipient Committee
STATEMENT OF ORGANIZATION
INSTRUCTIONS ON REVERSE
Page 3
COMMITTEE NAME I.D. NUMBER
Paul Brown SLO City Council 2013 1355992
4. Type of Committee (Continued)
Geueral Purpose Committee 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
SPofisored Committee List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE
Covittibutor Committe ❑j, — l Check box and provide the date this committee qualified as a small contributor committee. If the committee qualified as a
Date qualified small contributor committee on January 1, 2001, enter 1/1/01.
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.
FPPC Form 410 (January /05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)