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HomeMy WebLinkAboutJOHNSON 410 AMEND 3/31/16Statement of Organization COUNTY OF DOMICILE STATE JURIBDICTION WHERE COMMITTEE IS ACTIVE Kern NAMEOFPRINCIPAL0FFICIERan Ke Attach additional inlofmation on appropriately labeled continuation sheets. 3. Verification I have used all reasonable diligence in preparing this statement and to the best of penalty of perjury under the laws of the State of Calttam' hat t e o eg4in a tru Executedon 3/31/2016 W ! / .a SIBW Executed. 3/31/2016 BY IS" 0 11 i reasurer ana writer rnncipai Vmcers NAME OF TREASURER Bvetre Bakke STREET ADDRESS (NO P.O. BOX) ro„/ STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE NAMEOFPRINCIPAL0FFICIERan STREET ADDRESS (NO P.O. BOX) CRY STATE ZIPCODE AREACODEIPHONE contained herein is true arid complete. I certify under E%eatedon DATE SIBNAMBE OF CONTROLLING OFFICEHOLDER, GWeId VE. OR SAME MEASURE PRCp IGUrn Executedon nl DATE SpNRURE OF WNTROLLING CiFICENOLDER. GIAIDPiE.OR STgE MEABLWE PRDPONEM www.nefNa.eom FPPC Form 410 (JarJ2016) FPPC Advice: a IVICO&Ppe.u.gov (866/2754772) www.fpix,e .gW Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Johnson for City Council • All Committees mustlist thefinancial Institution where the campaign bankaccount is located. Bank STATE ZIP CODE Page 2 of 3 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, it any, and the year of the election. • List the political party with which each officeholder or Candidate is affiliated or check "nonpartisan." • If this committee acts jointly with another Controlled committee, list the name and identification number of the other controlled committee. ELECTIVE OFFICE SOUGHT OR HELD NAME OF CANDIDAVE/DFFICEHOLDERISTATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDITE(S) OFFICE SOUGHTOR HELD OR MEASURE(S) JURISDICTION CANDIDATE(S)NAME OR MEASURES) FULL TIRE (INCLUDE BALLOT NO. OR LETTER) (INCLUDE DISTRIOTNO., CITY OR COUNTY, ASAPPLICAELE) CHECK ONE FPPC Fonn 410 (JaN4016) www.netma.com FPPC Advlm: adrleatiIppe.ea.gov (86011753774) www.financ v City Counci: Nectar: Local District ] Q% Nonpartisan Russell Johnson 2018 E] Nonpartisan primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDITE(S) OFFICE SOUGHTOR HELD OR MEASURE(S) JURISDICTION CANDIDATE(S)NAME OR MEASURES) FULL TIRE (INCLUDE BALLOT NO. OR LETTER) (INCLUDE DISTRIOTNO., CITY OR COUNTY, ASAPPLICAELE) CHECK ONE FPPC Fonn 410 (JaN4016) www.netma.com FPPC Advlm: adrleatiIppe.ea.gov (86011753774) www.financ v Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 3 of 3 COMMITTEE NAME I.D. NUMBER Russell Johnson for City Council 2015 1 32 5514 4.Type of Committee (Continued) Not fonnedto support or oppose Specific candidates or measures in a single election. Checkw1yonebox: ❑ CITY Cammiltw 0 COUNTYCUmmleea ❑ STATECommfttse PROVIDE BRIEF DESCRIP'nON OFACTIVITY List additional sponsors on an amchment. GROUP Data quasar! 5.Termination Requirements Syslgning0,averMcatian, Metreeeurer. aeaislamtreesurerantl/ orcanditlete , officeholder, orpmponamoertilyl eatiolMafolkrwirlgc ftm have bean 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 Coda 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 (JarMIG) w ..naWla.cam FPPC Advise: a M..@fpps.se.gov (95&2753772) ..ropc.ca a W an w m O e.a Z to �o LJA. V V O CO to to w to N N 1 D 2 r2 D m 5 O 0 0 CA M D z a w https: / /www.fedex.com /shipping /html /en/Pri nllFmme.html mmea.. ca WM y T M 0 D �w r � W W D x � T T z 0 0 D 0 0 Cf-m A W X X sa„nwvnty n m x v p�4 A S�5 S� c After printing this label: 1. Use the'Print button on this page to print your label to your laser or inkjet printer 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the baroode portion of the label can be read and scanned. Warning: Use only the printed original label for shipping. Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing charges, along with the cancellation of your FedEx account number. Use of Mis system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fadex.mm.FedEx will not be responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, nondelivery,misdelivery,or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attorney's fees, costs, and other fortes of damage whether direct, incidental,consequential, or special is limited to Me greater of $100 or the authorized declared value. Recovery cannot exceed actual documented Ions. Maximum for items of extraordinary value is $1,000, e.g. jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide. Written claims must be fled within strict time limits, see current Fail Service Guide, I of 2 4/5/16,8:40 AM