HomeMy WebLinkAboutFRAZE 410 INITIAL 3/22/12Stptement of Organization
Recijpient Committee °' Ink
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Date qualified as con nlitlee Dale qualilled se con nklee
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1. Committee information
NAME OF COMMMTTEIE
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❑ Termination — See Part 5
List I.D. dumber:
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Dave of T F i L
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STATEMENT OF ORGANIZATION
RECEIVED Al !a'
in the office of tt ie S ., ct;
M 2.09 of the St to of z -'z
MAR 2 6 012
DEB B WI
2. Treasurer and Other
IT
APR -2 PM 4: 4 7
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COUNTY OF DOMICLE COUNTY WHERE COm mrrm ISACTIVE IF DIFFERENT
THAN COUNTY OF OOMlCILE
1�ern C -.rte e
Affect+ adliflional k*wmation on gppn*vi owy labelsd oor*mmjon ahseta
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NAME OF ASSISTANT TREASURER, IF ANY
S`nt f_TADDRE8S (NO P.O. BOA
CITY STATE ZIP CODE AREA CODEX*IONE
3. Verification
I have used all reasonable dlIgw a in preparing this statement and to the best of my knowledg=intffnafion ined is tru0 and complete. I certify under penally of
perjury under Ilm lawsof ftm State of California that the foregoing is true and correct.
Executed on _ " "� �/ By
DATE OF e187
ORAS W TREASURER
Executed on _ 21 —J401 Z--, � ---, By
DATE SIGNATURE OF CONUMMS OFFICENOLDEK CAN MATE. OR SDUTE MEASURE PnoPOrlENr
Executed on BY
8R3NATURE OF CONTROLLM1Ei OFFICEHOLDER. CAND09M OR STATE MEASURE vRaPONE++r
Executed on By
oATe
FPPC Form 410 (ApMAIII11)
FpPC Tov*rse NdpWle. SWASK -FPPC (OOfR'> 544)
_ (Slater lent of Organization
Re!�,'•%l mt: Committee
INSTRUCTIONS ON REVERSE
2
�.. I I ¢ ww= �--- / 6,/ LD. NUMBER
^4- 7` y 176
4. Type of Committee convww the applicable sections.
715A
• List the name of each conbolling officeholder, candidate, or state measure proponent If candidate or molder 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 dieck'rwn- partisan
• If this committee ads jointly with another controlled committee, Net the name and identification number of the other controlled oommittee.
ELECTIVE OFFICE SOUGHT OR HELD
NARK OF CANDIDA ATE MEASURE PROPONENT (I CWDE DISTRICT NUM BM IF APRKABLE) YEAR OF ELECTION PARTY
. List the financial Inefttion where the campaign bank account Is located (conWled 'cartdidde election' committees only)
ISTINTION
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Pbimariy fomned to support or oppose spedilc carmildeles or meawres in a singie election. List bebw.
CANDIDATE(S) NAME OR MEASURE(S) FULL TIRE (INCLUDE BALLOT No. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO„ CITY OR COUNTY, AS APPLICABLE) CHECK ONE
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FPPC Fora 410 (AprWMI)
FPPC ToNfree ltelpYne: $MASK-FPPC (05((275 -7712)