Form 410 Initial 05/16/18 f
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Statement of Organization -7 Date Stamp "2018 Recipient Committee statement Type ®initlal REC IVE® AN•l0� FIL.Et7❑ Amendment ❑ Termination—See Palrt the o of the Secretary of State fficial Use Only Q Not yet qualified of he State of California � ($ �i'� 7= 4,
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0 Data qualified as committee / / /--/ A 2 9 208
16 / 2018
Date qualified as committee Date of termination
/
I.D. Number /
Committee Information.,.,
1 2.,Treasurer and Other Principal Officers
(If applicable)
NAME OF COMMITTEE NAME OF TREASURER
Simon Mayeski
Jody Hubbard for City Council 2018
STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE
STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY
San Diego CA 92124 858-361-8223
MAILING ADDRESS(IF DIFFERENT) STREET ADDRESS(NO P.O.BOX)
E-MAIL ADDRESS(REQUIRED)/FAX(OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE
simon @mayeski.com
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(5)
San Diego Encinitas
STREET ADDRESS(NO P.O.BOX)
Attach additional information on appropriately labeled continuation sheets. CITY STATE ZIP CODE AREA CODE/PHONE
i
", 3.:Vei•i cation. a � _ _ _ _ _
I have used all reasonable diligence in preparing this statem t a to the best of my knowledge the information contained herein is1true and complete I certify under
penalty of perjury under the laws of the State of California hat going is and correct.
Executed on 05/16/2018 By L,
DATE IG URE OF TREASUR OR ASSISTANT TREASURER
Executed on 05/16/2018 By
DATE SIG ATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
FPPC Form 410(February/2018)
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
COMMITTEE NAME I.D.NUMBER
Jody Hubbard for City Council 2018
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
Mission Federal Credit Union 800-500-6328 Y3))/ -3
ADDRESS CITY STATE ZIP CODE
294 N El Camino Real Encinitas CA 92024
4.Typ1-oft Committee Com'pletethe'applicablesections
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• 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." 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.
ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY,
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
Nonpartisan Partisan (list political party below)
Jody Hubbard City Council, District 2018 ✓0
Nonpartisan Partisan (list political party below)
El
Formed Primarily Committee 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
IF A RECALL,STATE"RECALL"IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE
SUPPORT OPPOSE
El 1-1
SUPPORT OPPOSE
LL
FPPC Form 410(February/2018)
FPPC Advice:advice @fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
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