HomeMy WebLinkAboutDEAN 410 TERM 6/5/134p
Statement of Organization
Recipient Committee
Statement Type ❑ Initial
Not yet qualified ❑ or
I I
Date qualified as committee
Type or print in ink
❑ Amendment
List I.D. number:
Date qualified as committee
(If applicable)
Committee Information
NAME OF COMMITTEE
,2- d �-_ e Sf -a lG
XTermination — See Part 5
List I.D. number:
#�: -isle
6 , j , Z,9 1-3
Date of Termination
CITY � � � STATE ZIP CODE AREA CODE/PHONE �
OPTIONAL: FAX/ E -MAIL ADDRESS
" "?
COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE
Attach additional information on appropriately labeled continuation sheets.
LCEIVEi
in he office of the Sec; -Lary
of fha Cfatc,7: 'inrr
OCT 2 4 2013 ``'.,
Lek
Secretary of Mate
Treasurer and Other PH
NAME OF TREASURER
(/ ��\ /
�'
NAME OF ASSISTANT TREASURER, IF ANY l
(NO P.O.
NAME OF PRINCIPAL
STREET ADDRESS (W P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
3. Verification
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
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l 3
Zd j 3
By
Ph
DATE
SIGNATURE OF TREASURER OR ASSISTANT TREASURER
Executed on
G
t
DATE
y �" t
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
By
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
By
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (June /09)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)
f Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
OF ORGANIZATION
`C � i I.D. NUMBER
St- N Wr � v��, z
p tn 13 S';L9f
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.
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD
j� q (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
V �' 1 17 LJ f GI tf–� t S T w pr— `t� Z(� �3 Non - Partisan
`C'
❑ Non - Partisan
• List the financial institution where the campaign bank account is located (controlled "candidate election" committees only)
NAME OF FINANCIAL INSTITUTION AREA CODEIPHONE BANK ACCOUNT NUMBER
ADDRESS V r
Z5 iAit ZIP CODE
Primarily Formed Committee ; Primarily formed to support or oppose speck candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
FPPC Form 410 (June /09)
FPPC Toll -Free Helpline: 866/ASK -FPPC (866/2753772)
i-
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
STATEMENT OF ORGANIZATION
Page 3
-
�,� 3 JI.D. 3 5�Cs [ V
4. Type of Committee (Continued)
General Purpose Committee No rmed 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 1 p
Q• • -. . List additional sponsors on an attachment.
NAML OF SPONSOR
STREETADDRESS NO. AND S:
Date qualified
CITY
GROUP OR AFFILIATION OF SPONSOR
STATE
ermination Requirements signing 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;
• 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 (June /09)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
MARY B. BEDARD
AUDITOR - CONTROLLER - COUNTY CLERK
ELECTIONS OFFICE
RETURN SERVICE REQUESTED
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ELECTIbN MAILT.
AtdNRO by ft US. Postal Senb
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City of Bakersfield
Attn: City Clerk
SAP PON
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• 16 02 1M $ 00.405
V 0004232588 OCT 29 2013
MAILED FROM ZIP CODE 93301
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