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HomeMy WebLinkAboutKERN CITIZENS FOR PATIENT RIGHTS 410 AMEND 02/20/18Statbment of Organization ..."A., ,Kecippent Committee F ECEIVED AND I StattYnenl Type ❑ Initial ® Amendment ❑ Termination –See Parts it the office of the Seeman p Not yet pualifietl ?RIR FEB 20 PN 2- If of the Slate ofCalifor 0 0 Data qualified! as committee — —�m�;; . �r/—fj–y–}{ jt, FEB 02 2018 Date qualified as committee Date of terminatmn – I.D. Number (iJapvlicoblel 1340602 NAME or ConTMITTEE NAME or ,REAS.. KERN CITIZENS FOR PATIENT RIGHTS LAWRENCE R HIESTAND E Mui ADDRESS(REOUIRmu DOE (OPTIONAL) COLED1.1 LUILoCITTION WNENECOMMITTEE INACTIVE KERN Attach additional information on appropriately labeled continuation sheets. , .-It IJiBu ITY STATE HOLOO, AREA CODE/PHONE NAME Or ASSISTANT THEMOREL, IF ANN NAME OF PRINCIPAL OFF CER(S) JEFFREY G JARVIS penalty of perjury under the laws of the State of California that thef egos Is true and FRECIEW OF 1/302018 By Executed CRT By ITN STATE 1HEM.1 AREAI,DE/PHONE Executed OR By .ATE DENATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, CA STATE MEASURE PROPONENT Exerted On By A., 9ENANRE Or 0O111TROLLINS.11IRHOL.ar CAN0.AT500.1-1--.A'PROPCNEHT WPC Form 410 (October/2017) FPPC AM.: adNce@fppc.w.Bov (866/375-3772) www.fvpC.Ca.BOM Statiment of Organization 1111jecipient Committee Stafilment Type i]ln(tial Q Not yet qualified or O Date qualified as committee KERN CITIZENS FOR PATIENT RIGHTS ® Amendment [] Termination — See Part5 Date qualified as committee Date of termination 1340602 930 TRUXTUN AVENUE, # 102 Ley RATE :IPCOOE AREACEDEtPHONE E Rall ADDRRRR iRmNIRmt/. (OPTIONAL) Tyo MIO F LOLE ISOILTION INH ERE LDR-orru IS—FE KERN NAME OF THEAUSTREA LAWRENCE R HIESTAND ForaMURnIEe TELL :TATE APOODE AREA CODETPHONE NAME OF ASSISTANT TREASURER. IF ANN NAME OF PRINCIPAL OCEILEWS) LINDA G JARVIS CIT. STATE 'I'DDE ARLACODERHONE Attach additional information on appropriately labeled continuation sheets. 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 1/30/2018 By LAre RIGNA.URE DF TREARNRER OR ARRISTANTTREARORER Exemted On By LATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIWTC, OR STATE MEANTLE PROPONENT Executed on By DATE yGNATORE OF CONTROLLING OFFICEHOLDER, CANomATF, OR STALE MEASURE PROPONENT Executed on By DATE SIGNATURE HE CnHWO HRIG OF IFTHOLDER, CANDIDATE. ON STATE MLASDO PROPONENT FPPC Form 410 (October/2017) FPPC Advice: advicallihe c.ca.ew(866/275-3772) www1pPC.o,gov Statement of Organization - tteciptent Committee II E INSTRUCTIONS ON REVERSE ' PoRt COMMITL pMFryVMBEP KERNCITIZENSFOR PATIENT RIGHTS 1340602 All committees must list the financial institution where the campaign bank acetum is located. WELLS FARGO BANK • 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 parry with which each officeholder or candidate is affiliated or check "nonpartisan" Stating "No party preference' is acceptable. • If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. NAME OFCANOIDATE/OFFICENOLDF PRTATF MFASII P F PROJUNENT ELECTIVE OFFICE SO U 6RTIn NEIO YEAR OF PARTY Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDACIES) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLm NO. DR LETTER) CANDIDALEIS) OFFICE SOUGHT OR HELD OR M EASURUSLURISDICTION FIRM Form 410(0crober/201]) Clear Pa e.F--Pr—int--1 FRP[ Advice: advica@fppc.o.gov)g66/2]6-32]2) - www./PPc.ra.gov :oDRI oNSE N/A FIRM Form 410(0crober/201]) Clear Pa e.F--Pr—int--1 FRP[ Advice: advica@fppc.o.gov)g66/2]6-32]2) - www./PPc.ra.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Fap3 KERN CITIZENS FOR PATIENT RIGHTS 11340602 Not formed to support or oppose specific candidates or measures in a singleelection. Check only one box: 0 CITY Committee ❑ CID UNTYCommittee ❑ STATE Committee [IPolitical Party/Central Committee FORMED TO SUPPORT MEASURES FOR PATIENT RIGHTS AND OPPOSE THOSE THAT ARE NOT FOR PATIENT RIGHTS. List additional sponsors on an attachment. • 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 maybe 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. Clear Pa @ Print FPPC Form 410(0dober/201]) FPPC Advice: advicegfppcm.gov 1866/2]5-3]721 www.fppC.ca.gov