Form 410 Amendment '
—
CIT-y
Statement of Organization Date StaM.P Er
Recipient Committee
Statement Type [:] ,it,,, 0 Amendment El Termination—See Part 5 rFor.6-f0ii 6sa CA
0 Not yet qualified
or
0 Date qualification threshold met Date qualification threshold met Date of termination
08 13 1 2018
I.D.Number
on, .�:P2. Treas0rera Iii
(if applicable) 409436
[". , 11 1,-'.1
NAMEOFCOMMITTEE NAME OF TREASURER
Tony Brandenburg for Encinitas City Council 2018 Kevin K. Forrester
STATE ZIPCODE AREA CODEjP9ONE NAME OF ASSISTANT TREASURER,IF ANY
Encinitas CA 92024 780'932`0999
FULL MAILING ADDRESS(IF DIFFERENT) STREET ADDRESS(NO RM BOX)
E-MAILADDRESS(REQUIRED)/FAX(OPTIONAL) CITY STATE ZIP CODE AREACODE/PHONE
kovin@formstortmot.on
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S)
San Diego County City of Encinitas Anthony J. Brandenburg
Attach additional information onappropriately labeled continuation sheets. CITY STATE ZIP CODE AREA CODEIPHONE
Encinitas CA 92024 780'525'4569
I have used all reasona6le diligence in preparing this statement and to the best" nowledge the Information' contained herein is true and complete. I certify under
penalty of perjuty under the laws of the State of California that the foregoing t e nd c re
Executed on 08/24/2O18 By
DATE JLII�IRE OFXREASURER OR ASSISTANT TREASURER
�EOF.IIIASSISTAhTl
Executed on R uv
SIGNATURACIF CONTROLLING OFFICEHOLDER.CANDIDATE,OR STATE MEASURE PROPONE14T
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
n"nc Form 41o(x «)
rnpc Advice:aamce@,nnccauovmsofznsa77z>
wmxw., nco,.gom
Statement of Organization CALIFORNIA '
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
pop 2
COMMITTEE NAME I.D.NUMBER
Tony Brandenburg for Encinitas City Council 2018 1409435
All committees must list.the financial institution where the campaign bank account is located.
'NAME OF FINANCIAL INSTITUTION' AREACOOE/PHONE BANK ACCOUNT NUMBER
U.S.Bank 760-632-3620 157511145474
ADDRESS • CITY STATE ZIPCODE
131 N El Camino Real. Encinitas CA 92024
mss t1• �� Li�.���PPP+ Q� t�,4���','�j17Q1^1'�5 "'�.?dN{^','' ti 'ti" ���fl�y•°'Sy rs° �,.: s^Frmr�s:. T' ':l a� �it @e.�1 ��..3,• Y w
:.. ��1CL.d_��1�����i.1I�
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 ads 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 CAN DI DATE./OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECKONE
Nonpartisan Partisan illst political party below)
Anthony J.Brandenburg Encinitas City Council Member 2018
Nonpartisan Partisan plst politiral party beloW
E]
Primarily Fortned 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) CAN DIDATE(5)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION
IF A RECALL,STATE-RECALV IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE
SUPPORT OPPOSE
T
FPPC Form 410(August/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA
Recipient Committee FORM 4101
INSTRUCTIONS ON REVERSE
fFl.p 3
COMMITTEE NAME I.D.NUMBER
Tony Brandenburg for Encinitas City Council 2018 1409435
.7-57
W
Get7el'Cll Purpose Connnittee 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 DESCRIPTION OF ACTIVITY
List additional sponsors on an attachment.
NAME OF SPONSOR -------------INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO.AND STREET CITY STATE ZIP CODE AREA CODE/PHONE
Small Contributor Committee
13
Date qudfled
• 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.
FPPC Form 410(August/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www-fopc-ca-gov