HomeMy WebLinkAboutABRAHAM AMENDED 410 tatement of Organization
Recipient Committee
Statement Type [] Initial
Not yet qualified
'l~pe or print In Ink
I~mendment
List LD. number.
I I I I
Date qualified as committee Date qualified as committee
1. Committee Information
[] Termination - See Part 5
List I,D. number:
! I
Date of Termination
NAME OF COMMIYrEE
STATE ZIP CODE AREA CODFJPHONE
STREET ADDRESS (NO P.O. BOXy) L.
CITY
MNLING ADDRESS (IF DIFFERENT)
OPTIONAL: FAX I E-MAIL ADDRESS
COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE
Attach addi#onal information on appropriats~y labeled continuation sheets.
Date Stamp
STATEMENT OF ORGANIZATION
For Offidel Use Only
2. Treasurer and Other Principal Officers
OF T EASU ER
STREET ADDRESS
CITY
NAME OF ASSISTANT TREASURER, IF ANY
~,~5 ~'~.~..__
STATE ZIP CODE AREA CODFJPHONE
STREET ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
3. Verification
Ipeh;~;uusneddera~hr; laaSwO~aol~l!hdeil~gteatneCeoif%Parli~oPam~angtl~:itsths~a~foemm;onltn;nids tt%teh~nb~,~ tco~J~ kno~_e~e inform,.~on¢ nlained herein is tru~/,~d complete. I ce~r penalty of
Executedon By
DATE SIGNATURE OF CONTROLLING O~FICEHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT
Executed on By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (Janl01)