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HomeMy WebLinkAboutSTEVENS 410 INITIAL 09/23/20Statement of Organization Recipient Committee Statement Type I have used all reasonable"diligence In preparin this stat err' ent and to the best of m penalty of perj ry "nd r the laws of the State y knowled e t f alifor i g he inforhe•.�.�.� ti`;.«' ,.,:.�t; �� i :. .._._��. j �] �J t t the foregoing is true and correct. mation contained rein is true and complete. I certify under Executed on. /JDA/T,E Executed on 1 lJ /iV2� DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Gxec;III vrl (In By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, Oq STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING)FFICEHOLDER, CANDIDATE, OR STATEMEASURE PROPONENT Fppr tii— A -in el W; Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME Ccx� C,r All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIALIN5T UTION Page 2 I.D. NUMBER Controlled Committee • 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. • I,Ist the political party with which each officeholder or candidate is affiliated or check "nonpartisan." Stating "No party preference" is acceptable. • II this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY r OCTIrIN 1-1.-1. NAME QI' CAN DIDATE/OFFICEHOLUEH/b1A1 t IvitH}Vnt rnur-- d \I . ��v • �• •-•••--•• •• • • - ---• Nonpartis Partisan (list political party below) C� C� �� I �� ��� below) " �r / Nonpartisan Pan (list politica party Primarily Formed committee 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 MEASURES) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE L FPPC Form 410 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov I 1, jatement of Organization ecipient Committee -Ili IICrIDNS ON REVERSE I11; NAME General 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 VIIIL MIKA DESCRIPTION OF ACTIVITY List additional sponsors on an attachment. r I ill '.PUNS01t GROUP OR AFFILIATION OF SPONSOR Page 3 71-1 AIIDIII SS NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE Sniall Contributor❑ Date qualified r' r ievo ceder ar` k to hat: I thefolltwln eo ditibnsia been a o the'h' o ficanorf�, f a user, as9istafittr asa <a�d 'cari 0, ff1 �d prQ dja .nt, Ke In Term n tiw n r„... , �:,.. R,,9� _ �!,.u.� ;:. w<..r_ �. ,,....>� :.,.,•..t!r=.. ; ri ., _,... 1.a ., 'I•Itl:'s Committee has ceased to receive contributions and make expenditures; • I lds c m miave does not anticipate receiving contributions or making expenditures in the future; • I MI's cimimitiee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; • '1 his committee has no surplus funds; and I'Ills committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. Thore 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. Lultover 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 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov