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HomeMy WebLinkAboutHANSON 410 AMEND 12/31/14ti Statement of Organization Recipient Committee Statement Type ❑ Initial Not yet qualified ❑ or t?� Amendment List I.D. number: AA "' Date qualified as committee Date qualified as committee (If applicable( RECEIVED 1701W646- *Marg5 5 7 List I.D. number: KERN Y ®/t _ I.CYI�NS / 0 Date of Termination Date Stamp For Official Use Only IS r rzt u i I "i y FED -°G� 1. Committee Information: 2. Treasurer and Other principal Officers NAME OF COMMITTEE NAME OF TREASURER s 0 k 4 6 0 NA�s4,, A ,ti �.,= v,,J�,t, 'wALaA "Aa� .I STREET ADDRESS (I O. BOX) I STREET ADDRESS(NO O. BOX) NAME OF ASSISTANT T EASURER, IF ANY FAX / E -MAIL ADDRESS OF DOMICILE WHERE COMMITTEE 15 ACTIVE STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE NAME OF PRINCIPAL OFFICER($) Attach additional information on appropriately labeled continuation sheets. STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE 3. Verification I have used all reasonable diligence in preparing this statement and to the best of my now ledge the information contained herein is true and complete. I certify under penalty of perj ry u der the laws of the State of t$lifornia that the foregoing 's tru nd correct. Executed on By DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER Executed on i- % Q« By iv�� �• DATE SIGNATURE Ot CONTROLLING C OLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE. OR STATE MEASURE PRO Executed on DATF. By NG OFF RE 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 COMMMTTEE NAME ` � e O +i ARor.� •'� \11 _ T:- it • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION �t-t "1tEas '&`%, AOORESS %��oo h'14;V. AREA CODE /PHONE ��1 - ^x%�- 03aS CITY KA %w BANK ACCOUNT NUMBER STATE ZIP COOS CA, �y' nc `i Page 2 I.D. NUMBER ia�SZSo • 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. ELECTIVE OFFICE SOUGHT OR HELD NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY © 1 U1 � j Nonpartisan t qko ,.'b ❑ Nonpartisan Committee Primarily Formed Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATES) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE I cuPPORT I OPPOSE 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 3 COMMITTEE NAME \ n 1 p (y I I General l 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 5ponsored Committee List additional sponsors on an attachment. NAME OF SPONSOR STREET ADDRESS NO. AND STREET CITY GROUP OR AFFILIATION OF SPONSOR STATE ZIP CODE Small Contributor Committee Date qualified 5: Terrirtin ii©n i quia ements Bp3iBnf[ tfi vetiftcatiC eheEieas idate ,aHicetio;Lie�;c�rpr2ipt►iTe ceri3fyiitataftnEti ra;law;i cuna c stet+ eri moistanttremrit�ndondue 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