HomeMy WebLinkAboutPLUMBERS AND STEAMFITTERS 410 AMEND (2)Statement of Organization
Recipient Committee
Statement Type F7 Initial
Not yet qualified D or
Date qualified as Committee
1. Committee Information
NAME OF COMMITTEE
P_uni•r cs ood ELCanta Lars LcceL 4aU P.:,.
STREET ADDRESS I— PO. PDX)
l71 Amendment
List I.D. number
# 1'9026 °.
p2 I 1] / [OL F.
Date qualified as committee
I, aeWAnMe)
D Termination - See Part 5
List I.D. number:
�—�
Date OfTermination
LITV STATE ZIP LODE AREA COOEIPHONE
M AILING AUcnEsS (IF DIFFERENT)
FAX I EMAIL ADDRESS
COUNTY TY O OF F DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
-i Ly cf 9akcce Cield
Attach additional information on appropriately labeled continuation shoals.
FIR 12 Ali 10:59
2. Treasurer and Other Principal
NAME OF TREASURER
i M. L�loe e
STREET ADDRESS (NO P O. BOX)
NAME OF ASSISTANTTREASURER. T ANY
ADDRESS)NO
CITV STATE 216 CODE AREA COUF1PHONE
NAME OF PRINCIPAL OFF) CER(5)
CLers•o M. Lco�a =. Pd adpal Otti car
STREET ADDRESS )NO P.0. 90X)
CITY STATE ZIP CODE AREA OODEPHONE
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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 Californi��l the foregoin - true and Correct.
Executed on A"` 0 7 1017 �' ti �N RFASU slsT rvrT u
Executed on
slcrvRURE
OF CONTROLUrvG
OFncsnolDER
CnNDIDRE. oR STATE MEASURE PROPONENT
DATE
Executed On
®J
SIGNWU0.E
OF CONTROLLING
OFFICEMOLOER
CPNDIDWE OR STATE MEASURE PROPONENT
OATS
Executedon
pATF
SIGNRURE
OF CONTROLLING
OFFICEHOLDER,
LANDIDW9 LR STATE MEASURE PROPONENT
FPPC Form 410 (dan12816)
www.neHile.com FPPC Advice: advice @fppo.ca.gov (8661
wwwlppo-ca.9av
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
2a. Additional Officers / Assistant Treasurers
Jesse R. Roman, Principal Officer
MAILING ADDRESS
CITY
STATE
21.000E
AREACODE /PHONE
NAME
Edward Azambula, Jr., Principal offieer
MAILING ADDRESS
Clil,
STATE
ZIP CODE
AREA CODE /PHONE
NAME
MAILING ADDRESS
CITY
STATE
21P CODE
AREACWE /PHONE
NAME
MAILING ADDRESS
CITY
STATE
ZIP CODE
AREA CODEIPHONE
Ww netfile.com
Page 2 Of 4
1280263
Cltt STATE ZIPCODE AREA CODE /PHONE
MAILING ADURE55
CITY STATE ZIP CODE AREACODE /PHONE
Clry STATE ZIP CODE AREACODE /PHONE
NAME
MAILING ADUHeSJ
CITY STATE DECODE AREACODE/PHONE
FPPC Form 410 (Jan12016)
FPPC AdMII advice@fppc.w.gov (866127 3112)
v Jppc.w.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON RE VERSE
Steamfittere Local 460 PAC
• All committees must list the financial institution where the campaign bank amount is located.
Wells Fargo Bank
STATE
Page 3 of 4
4.TypeofCommittee Complete the applicable Sections.
• List the name of each controlling officeholder, candidate, or slate 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 CANDIDHNOFFICEHOLDER JSTATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
Nonpartisan
Nonpartisan
Primany fomledtosePPOd oroppose swurficcandidates ormeasores in a single election. Listbelow:
• ,
CANDIDATE(S) OFFICE SOUGHTOR 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)
.Y
FPPC Form 410 (Jan/2016)
www.netfite.rom FPPC AWlce: advlce@fppc.ca.gov (86612753772)
www.fpPc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Plumbers and Steamfitcena Local 460 PAC
4. Type of Committee (Continued)
Not formed to support or oppose specific candidates or measures in a single election. Check only one box'
E] CITY Committee ❑ COUNryCommittee ❑ STATECommittee
To support or appose state and local candidates
List additional sponsom on an attachment.
NAME OF
Small Contributor Committee
Page 4 of 4
1280263
5.Termination Requirements By signing the verification, the treasurer, assistant treasurer and/orcandidate, officeholder, orproponent cediry 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 fled 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 Cade Section 18680 and FPPC Regulation 18521.5.
FPPC Form 410 (Jan/2016)
www.netfilacom FPPC AMice: advice @fpPc.Ca.gov (86612153112)
www.fpPC.Ca.gov