HomeMy WebLinkAboutKERN CITIZENS FOR PATIENT RIGHTS 410 AMEND 02/20/18Statbment of Organization ..."A.,
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Date qualified as committee Date of terminatmn –
I.D. Number
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NAME or ConTMITTEE NAME or ,REAS..
KERN CITIZENS FOR PATIENT RIGHTS LAWRENCE R HIESTAND
E Mui ADDRESS(REOUIRmu DOE (OPTIONAL)
COLED1.1 LUILoCITTION WNENECOMMITTEE INACTIVE
KERN
Attach additional information on appropriately labeled continuation sheets.
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ITY STATE HOLOO, AREA CODE/PHONE
NAME Or ASSISTANT THEMOREL, IF ANN
NAME OF PRINCIPAL OFF CER(S)
JEFFREY G JARVIS
penalty of perjury under the laws of the State of California that thef egos Is true and
FRECIEW OF 1/302018 By
Executed CRT
By
ITN STATE 1HEM.1 AREAI,DE/PHONE
Executed OR By
.ATE DENATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, CA STATE MEASURE PROPONENT
Exerted On By
A., 9ENANRE Or 0O111TROLLINS.11IRHOL.ar CAN0.AT500.1-1--.A'PROPCNEHT
WPC Form 410 (October/2017)
FPPC AM.: adNce@fppc.w.Bov (866/375-3772)
www.fvpC.Ca.BOM
Statiment of Organization
1111jecipient Committee
Stafilment Type i]ln(tial
Q Not yet qualified
or
O Date qualified as committee
KERN CITIZENS FOR PATIENT RIGHTS
® Amendment [] Termination — See Part5
Date qualified as committee Date of termination
1340602
930 TRUXTUN AVENUE, # 102
Ley RATE :IPCOOE AREACEDEtPHONE
E Rall ADDRRRR iRmNIRmt/. (OPTIONAL)
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F LOLE ISOILTION INH ERE LDR-orru IS—FE
KERN
NAME OF THEAUSTREA
LAWRENCE R HIESTAND
ForaMURnIEe
TELL :TATE APOODE AREA CODETPHONE
NAME OF ASSISTANT TREASURER. IF ANN
NAME OF PRINCIPAL OCEILEWS)
LINDA G JARVIS
CIT. STATE 'I'DDE ARLACODERHONE
Attach additional information on appropriately labeled continuation sheets.
1 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.
Executed On 1/30/2018 By
LAre RIGNA.URE DF TREARNRER OR ARRISTANTTREARORER
Exemted On By
LATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIWTC, OR STATE MEANTLE PROPONENT
Executed on By
DATE yGNATORE OF CONTROLLING OFFICEHOLDER, CANomATF, OR STALE MEASURE PROPONENT
Executed on By
DATE SIGNATURE HE CnHWO HRIG OF IFTHOLDER, CANDIDATE. ON STATE MLASDO PROPONENT
FPPC Form 410 (October/2017)
FPPC Advice: advicallihe c.ca.ew(866/275-3772)
www1pPC.o,gov
Statement of Organization -
tteciptent Committee II E
INSTRUCTIONS ON REVERSE
'
PoRt
COMMITL pMFryVMBEP
KERNCITIZENSFOR PATIENT RIGHTS
1340602
All committees must list the financial institution where the campaign bank acetum is located.
WELLS FARGO BANK
• 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 parry with which each officeholder or candidate is affiliated or check "nonpartisan" Stating "No party preference' is acceptable.
• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
NAME OFCANOIDATE/OFFICENOLDF PRTATF MFASII P F PROJUNENT
ELECTIVE OFFICE SO U 6RTIn NEIO YEAR OF PARTY
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDACIES) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLm NO. DR LETTER)
CANDIDALEIS) OFFICE SOUGHT OR HELD OR M EASURUSLURISDICTION
FIRM Form 410(0crober/201])
Clear Pa e.F--Pr—int--1 FRP[ Advice: advica@fppc.o.gov)g66/2]6-32]2)
- www./PPc.ra.gov
:oDRI
oNSE
N/A
FIRM Form 410(0crober/201])
Clear Pa e.F--Pr—int--1 FRP[ Advice: advica@fppc.o.gov)g66/2]6-32]2)
- www./PPc.ra.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Fap3
KERN CITIZENS FOR PATIENT RIGHTS 11340602
Not formed to support or oppose specific candidates or measures in a singleelection. Check only one box:
0 CITY Committee ❑ CID UNTYCommittee ❑ STATE Committee [IPolitical Party/Central Committee
FORMED TO SUPPORT MEASURES FOR PATIENT RIGHTS AND OPPOSE THOSE THAT ARE NOT FOR PATIENT RIGHTS.
List additional sponsors on an attachment.
• 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 maybe 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.
Clear Pa @ Print FPPC Form 410(0dober/201])
FPPC Advice: advicegfppcm.gov 1866/2]5-3]721
www.fppC.ca.gov