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HomeMy WebLinkAboutLOUIE 410 08/06 Statement of Organization Recipient Committee Statement Type ~al Not yet qualified 0 or STATEMENT OF ORGANIZATION Type or print in ink DateSlamp CALIFORNIA 41 0 FORM o Amendment List 1.0. number: o Tennination - See Part 5 List 1.0. number: For Official Use Only 06A -I PH 2: 30 # # I I Date qualified as committee I I Date qualified as committee (If applicable) BAKER~ :jELO CI1 Y CLERK ----1----1_ Date of Termination 1. Committee Information NAME OF COMMITTEE 2. Treasurer and Other Principal Officers NAME OF TREASURER So.ro.. ~ lo ~ ~ e... STREET NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE opnONAL: FAX I E-MAIL ADDRESS " COUNTY OF DOMICilE ~ e("C\ COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICilE Attach additional information on appropriately labeled continuation sheets. 3. Verification I have 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 perjury under the laws of the State of California that the foregoing is true and correct. 0 >'~. , Executed on 7L2e/200~ By ~ _ Ii - J' DATE ...........SSII~GNAR REEOFOF}l'}l'EASURERDRASSISTANTTREASURER Executed on ~/28._2DO" By ~ ~ DATE SIGNATURE OF CONTROLLING OFFICEHOlDER, CANDIDATE. OR STATE MEASURE PROPONENT Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOlDER, CANDIDATE. OR STATE MEASURE PROPONENT Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOlDER, CANDIDATE. OR STATE MEASURE PROPONENT FPPC Fonn 410 (January/OS) FPPC ToIl-Free Helpline: ~661ASK.fPPC (8661275-3n2) Statement of Organization Recipient Committee STATEMENT OF ORGANIZATION INSTRUCTIONS ON REVERSE CAL f-Of.zNIA 41 0 FOR'" COMMITTEE NAME L\T\:2ex\S foe C~ l.olA\~ 1.0. NUMBER 4. Type of Committee Complete the applicable sections. (c}fltrl)!!' ti ClJ{nnllt!/). · Ust 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. · Ust the political party with which each officeholder or candidate is affiliated or check "non-partisan." · If this committee acts joinUy with another controlled committee, list the name and identification number of the other controlled committee. NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF aECTION PARTY --- thaA 1-0 l^\ ~ &~~~ C,"I (Ouct\ \J Uhai 5 2oofo B"Non-Partisan o Non-Partisan · Ust the financial institution where the campaign bank account is located (controlled "candidate election" committees only) ADDRESS Prlfl'7r1ly F~rnll I C I) 11'ltr,. Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INClUDE DISTRICT NO., CITY OR COUNTY, ASAPPt,ICABLE) I=l~ CANDIDATE(S) NAME OR MEASURE(S) FUll TITLE (INClUDE BAllOT NO. OR lETTER) FPPC Form 410 (J...-r/I5) ,I FPPC ToII.f,.. Helpline: 88IIASK-FPPC (11I/275-3772)