Form 410 Initial Statement Statement of Organization COPY Date Stamp 'CALIFORNIA
Recipient Committee 01 "Y i''1 FORM
StatementType [Initial ❑ Amendment ❑ Termination—See Part 5 r,l f For Official use only
Not yet qualified or List J.D.number: List I.D.number: q0 t, t IJ G 0 9 1
# If
Date qualified as committee Date qualified as committee Date of Termination
(if..Cllcable)
NAME OF COMMITTEE NAME OF TREASURER _
CC,mi-A, tr O�Q°Sedl }o Lr�cini}ctS $fug l hteCS
T
STREET
ZIP CODE AREA CODE/PHONE NAME OF ASS15TANT TREASURER,IF ANY
Enc-t•7%1-as CA 9Z-OZ`{ - 6877 ell
t at,b. n FhlcCs
MAILING ADDRESS(IF DIFFERENT) STREET
FAX/E-MAIL ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE
TV-40 C C—nC,ni}g5Sav VYx E"c.►rl1-�aS CA `I7-D2-4 760 -944-R 482
COUNTY OF DOMICILE D IU RISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICERS)
Sotcyws
o Cil-y 01 Cinci v,1-kts SusA�. Turr�cy
STREET
-
CITY STATE ZIP CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets. C�C, h;+O.Es CA 1Z0Z4 85's -584- 370 S
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 at the fEL/y,�/`�y,p{hg's true and correct.
Executed on CJ - t-7 - Z-o(G By Calif�ZZd ( y�
DATE - / / r �GNATURE OFTREASURER OR ASSISTANT TREASURER
Executed on i By �` � L �,Z // L
DATE J� SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,DR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDAI E,OR STATE MEASURE PROPONENT
FPPC Form 410(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA
Recipient Committee FORM
INSTRUCTIONS ON REVERSE page 2
I .NUMBER
COMMITTEE NAME
COrnrnii ee osc,cd -b ev e-'1 6+ms McCts Ore T
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION ABEACODE/PHONE BANK ACCOUNT NUMBER
C husc F",Or,k (760) 03 - l8 l'} 87ZOOZ71
ADDRESS CITY STATE ZIPCODE
(G5 N, El G.-.nnino 1Zca�� EInc:% Al qS CA 12-OZq
I
• 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"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 CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
❑ Nonpartisan
❑ Nonpartisan
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S)NAME OR MEASUREISI FULLTITLE(INCLUDE BALLOT NO.OR LETTER) CANDIDATE(S)OFFICE SOUGHT OR HELDOR MEASURE(S) URISDICTION
(INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE
SUPPORT OPPOSE
F1 I xi-
SUPPORT I OPPOSE
FPPC Form 410(Jan/2016)
FPPC Advice:advice @fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA '
Recipient Committee •
INSTRUCTIONS ON REVERSE Page
COMMITTEE NAME I.D.NUMBER
Com.m;�'ee. Q poSeQ -t-o s.x�rc l
.° Wo NOW
Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee❑ STATE Committee
PROVIDE BRIEF DESCRIPnoN 01 ACTIV'TY
List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO AND STREFT CITY STATE ZIP CODE
❑
wee R�allnea
:,.,. ,:.. I ..I:.,:.
• 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 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(Jan/2016)
FPPC Advice:advice @fppc.ca.gov(866/275-3772)
www.fppc.ca.gov