HomeMy WebLinkAboutDEAN 410 TERM 09/28/12 W N n
m m m m -0 n. n
�
l S
N 2 c g.G) G) c) n N D C7 D N D �I N \- c N
g M m m m M m et'D g_ N m —
m m m m -i O O -1 p y 7
O 0 0 0 0 o � � �
Statement of Organization STATEMENT OF ORGANIZATION
Recipient Committee 1
INSTRUCTIONS ON REVERSE Pay 2
I.Q. NUMBER
COMMITTEE NAME VA ��' L N N S w `4 2;_0 �° c.d v I `� I�, Z -1-1 Z -7
4. Type of Committee complete the applicable sections.
• 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 'non- partisan "
• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
ELECTIVE OFFICE SOUGHT OR HEIR
NAUF nF r`.ANnInATE/OFFICEHOLDERl8TATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
YV1�'t�J I N x-1`3
.�
-�- ww Gl �����(
2-0 ( -0
- Partisan
❑ Non - Partisan
. List the financial institution where the campaign bank account is located (controlled "candidate election" committees only)
NAME OF FINANCIAL INSTITUTION AREA CODEIPHONE
ADDRESS
/lliliWl� I I�VI�IUCJ�
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
OR LETTER
CANDIDATE(S) OFFICE SOUGHT OR HEIR OR MEASURE(S) JURISDICTION
CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO ) (INCLUDE DISTRICT NO., CRY OR COUNTY, AS APPLICABLE) CHECK ONE
FPPC Form 410 (AprW2011)
FPPC Tog-Free H•lplkw: 866/ASK -FPPC (86612753772)
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
AITTEE NAME
4. Type of Committee (Continued)
Not fomted to support or oppose specific candidates or measures in a single election. Check only one box:
ITY Committee ❑ COUNTY Committee ❑ STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
64 `^G(l d
List additional sponsors on an attachment.
NAME OF SPONSOR
m
CITY
GROUP OR AFFILIATION OF
STATEMENT OF ORGANIZATION
P.O. s
ZZ ! z7
5. Termination Requirements By
Date qualified
the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that all of the following conditions have been met:
• This committee has ceased to receive Contributions and make expenditures;
) / ' ---- 5
• This committee does not anticipate receiving contributions or making expenditures in the future; Y-1-2S
• This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; Y-e-
S
• This committee has no surplus funds; and �' 5 N i9 T, �--d S�)
• This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. �-es
- There are restrictions on the disposition of su ls Campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to
Government Code Section 89519. N 0 ! --. as
- Leftover funds of ballot measure committees may be used for political, legislative or govemmental purposes under Govemment Code Sections 89511 -
89518, and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5. Ok--' C N'
FPPC Form 410 (AprIU2011)
FPPC Toll -Free Helpllne: 8661ASK-FPPC (8661275-3772)