HomeMy WebLinkAboutSULLIVAN 410 TERM 06/30/02Statement of Organization
~Re(~pient,Corr[mittee
Type or print in ink
Date Stamp
STATEMENT OF ORGANIZATION
Statement l~/pe [] Inldal [] Amendment
Not yet qualified [] or List I.D. number~
I I
Date qualified as committee Date qualified as committee
tif ap~ica~)
1. Committee Information
~] Termination - See Part
List I.D. number:.
Date of Termination
C ,! ZIP E
MAILING ADDRESS (IF DIFFE~NT)
OPTIONAL: FAX / E-MAIL ADDRESS
JUL 31 P, I 56
!RSFIELD CITY CLERK
COUNTY OF DOMfCILE
2, Treasurer and Other Principal Officers
ST:RE'ET ADDRESS ~ ' 0 ~'
STAT E~ ZIP ~DE ~ COD~H~E
A#ach addi#Dnal information on appropriately labeled con~Duation $/~eels.
CITY STATE ZIP CODE AREA CODE/PHONE
NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
3. Verification
I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information/cpntalned herein is true and complete.
perjury under the law~ of the State of California that the foregoing is tree and correct.
Executed on
I certify under penalty of
FPPC Form 4tO (Jan/01)
FPPC Toll-Free Heleline: 866JASK-FPPC
State .merit of Organization
keciplent C6mmittee
INSTRUCTIONS ON REVERSE
4. Type of Committee Cornpiete the applicable sections.
STATEMENT OF ORGANIZATION
· 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 w~lh another controlled committee, Fist the name and identification number of the other controlled committee.
ELECTIVE OFFICE SOUGHT OR HELD
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBE
[] Non. Pa~san
· L~st the financial ~nstitut~on where the campaign bank account is located (controlled ,,candidate election, committees only)
NAM~ FINANCIAL INSTITUTION
AREA CODE~°HONE ~ BANK ACCOI~NT · /
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., cl'r~ OR COUNTY, AS APPLICABLE)
CH~(K ONE
FPPC Fon~ 4t8 (Jan/01)
FPPC Toll-Free Hell]lire: 8~/ASK-FPPC