HomeMy WebLinkAboutSULLIVAN 410 AMEND 01/31/14Statement of Organization
Type or print In Ink
Recipient Committee
Statement Type ❑ Initial 0 Amendment
Not yet qualified ❑ or List I.D. number.
# 950347
—J I I I
Date qualified as committee Date qualified as committee
(M applicable)
STATEMENT OF ORGANIZATION
Date Stamp
❑ Termination — See Part 5 n I n 1 t For Official Use onyx
List I.D. number.
_ . 1
Date of Termination
1. Committee Information
NAME OF COMMITTEE
Jacquie Sullivan for City Council 2012
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODEIPHONE
MAILING ADDRESS (IF DIFFERENT)
OPTIONAL: FAX/ E -MAIL ADDRESS
COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE
Kern
2. Treasurer and Other Principal Officers
NAME OF TREASURER
Tracey Reynolds
STREET ADDRESS
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
NAME AND POSITION OF OTHER PRINCIPALOFFICER(S), IF APPLICABLE
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
3. Verification
I have used all reasonable diligence in preparing this statement and to the best of my kn ledge th ation contained h is true and complete. rt1 er penalty of
perjury under the laws of the State of California that the foregoing is true and correct.
Executed on 01/31/14 By
DATE ,'SIGNATURE OF TR URER AS TANT TREAS ER
Executed on 01/31/14 By y
dr IGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on gy
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 (January/05)
FPPC Toll -Free Helpline: 8661ASK -FPPC (8661275.3772)
Statement of Organization
Recipient Committee
Statement Type ❑ Initial
Not yet qualified 0: or
_J— I
Date qualified as committee
1. Committee Information
NAME OF COMMITTEE
Jacquie Sullivan for City Council 2012
STREET ADDRESS (NO P.O. BOX)
Type or print in Ink
E' Amendment
List I.D. number.
# 950347
Date qualified as committee
(If applic0e)
Q Termination — See Part 5
List LD. number.
_I I
Date of Termination
CITY STATE ZIP CODE AREA CODE/PHONE
MAILING ADDRESS (IF DIFFERENT)
OPTIONAL: FAX /E -MAIL ADDRESS
COUNTY OF DOMICILE I COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE
Kern
Attach additional information on appropriately labeled continuation sheets.
3. Verification
I have used all reasonable diligence in preparing this statement and to the best of my
perjury under the laws of the State of California that the foregoing is.true and correct.
Executed on 01/31/14 By
DATE
Executed on 01/31/14 By .
DATE
Executed on
Executed on
DATE
DATE
STATEMENT OF ORGANIZATION
Date Stamp
14 4: L 1
2. Treasurer and.Other Principal Officers
NAME OF TREASURER
Tracey. Reynolds
STREET ADDRESS
For Official Use Only
CITY STATE ZIP CODE AREA CODE /PHONE
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE .
NAMEAND POSITION OF OTHER PRINCIPAL OFFICER(S), IFAPPLICABLE
MAILING ADDRESS I
CITY STATE ZIP CODE AREA CODE/PHONE
contained h9re r is true and complete. ,J e6rhf9y"un&r penalty of
CANDIDATE. OR STATE MEASURE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE, OR STATE MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (January/05)
FPPC Toll -Free Helpline: 8661ASK -FPPC (866/275.3772)