Form 410 Termination 07/20/10Statement of Organization
Recipient Committee Type or print in ink
Statement Type ❑ Initial ❑ Amendment
Not yet qualified ❑ or List I.D. number:
_J_ If
Date qualified as committee Date qualified as committee
(If applicable)
® Termination - See Part 5
List I.D. number:
# 1303536
6 / 30 / 2010
Date of Termination
Date Stamp
010 AUG -2 Pty 2: 07
1. Committee Information
NAME OF COMMITTEE
Re-Elect Jerome Stocks
STREET ADDRESS (NO P.O. BOX)
132 North El Camino Real, Suite 331
CITY STATE ZIP CODE AREA CODE/PHONE
Encinitas CA 92024 760-815-7787
MAILING ADDRESS (IF DIFFERENT)
P.O. Box 448 Oceanside, CA 92049
OPTIONAL: FAX/ E-MAIL ADDRESS
COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE
San Diego
Attach additional information on appropriately labeled continuation sheets
STATEMENT OF ORGANIZATION
For Official Use Only
2. Treasurer and Other Principal Officers
NAME OF TREASURER
Mary Azevedo
STREET ADDRESS
1734 S Pacific St.
CITY STATE ZIP CODE AREA CODE/PHONE
Oceanside CA 92054 760-439-5979
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS
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 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 By Lf ' U
DATE S
ATUR OF TREASURER OR ASSISTANT TREASURER
Executed on ` -
DATE BY_ _ C....
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
DATE
Executed on
DATE
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: 866/ASK-FPPC (866/275-3772)
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
OMMITTEE NAME
Re-Elect Jerome Stocks
NT OF ORGANIZATION
I.D. NUMBEF
1303536
4. Type of Committee Complete the applicable sections.
Controlled Committee
• 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
(INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
Jerome Stocks ® Non-Partisan
Encinitas City Council 2008
Non-Partisan
• List the financial institution where the campaign bank account is located (controlled "candidate election" committees only)
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
Union Bank of California 760-722-1631 0170033493
ADDRESS CITY STATE ZIP CODE
840 South Coast Highway Oceanside CA 92054
I Primarily • Committee I Primarily formed to support or oppose specific 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
SUPPORT OPPOSE
OPPOSE
FPPC Form 410 (January/05)
FPPC Toll-Free Heipline: 866/ASK-FPPC (866/275-3772)