Form 410 Termination COPYCITY OF EVI'CHNIITAS
Statgment of.Organi2ption 4 Date Stamp .
Recipient Committee 019 JAIL -4 PH 3: • - '� � '�
Statement Type D Initial b Amendment is Termination—' See Part 5 For otBcial use only
Q Not yet qualified
or
Q,Date qualification threshold met Date qualification threshold met Date oftemlination
12 3112018
I.D.Number I, k } a" s ie
4 CQmmitteevinformat±nn (if app
1409435 12 T -10andgOt�ter Pilncipa)Officers IJ -0F
NAME OF COMMITTEE NAME OF TREASURER
Tony Brandenburg for Encinitas City.Council 2018 Kevin K. Forrester
STREETADORESS(NO P.O.BOX)
STATE ZIP CODE AREA CODE/PI ONE NAME OF ASSISTANT TREASURER,IF ANY
Encinitas CA .92024 760-932;0999
FULL MAILING ADDRESS(IF DIFFERENT) - STREET ADDRESS IND P.O.BOX)
E•WIAIL ADDRESS(REQUIRED)/FAX(OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE
kevin @forrestertrust.co
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S)
San Diego.County City of Encinitas Anthony J.Brandenburg
STREET ADDRESS(NO P.O.BOX)
648 Lomas de Oro
CITY STATE ZIP CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets. Encinitas GA 92024 760 7525,4569
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4tiI have used all reasonable diligence in preparing this statement and to the best of my knowledge e' rmatio 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
Exgcdt.ed an 12/31/2018 By
DATE SI 0.TU 5 ROR 1ST NT TR fl
Exgcdted on 12/31/2018 By
DATE SI EOFCO fl LLIN I1 GOFFI TATEMEA ROPONENT
Exgcdted on By
DATE SIGNATUfl�V CONTROLDNG OFFICEHOLDER.CANDI DATE,OR STATE MEASURE PROPONENT
Exgcdted,on gy
DATE SIGNATURE F CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
FPPC Form 410(August/2018).
FPPC Advice:advice @fppc.ca:gov(866/275-3772)
www.fppd.ca.gov
Statement of Organigation •- '
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME LO.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 AREACODE/PHONE BANK ACCOUNT NUMBER
U.S.Bank 760,632-3620 157511145474
ADDRESS CITY 'STATE ZIPCODE
131 N El Camino Real Encinitas CA 92024
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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 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 CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
Nonpartisan Pan (list'political party below)
Anthony J.Brandenburg Encinitas City Council Member 2018
Nonpartisan Partisan (list political party below)
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) CANDIDATEIS)OFFICE SOUGHT OR HELD OR MEASURES)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
T
FPPC Form 410(August/2018)
FPPC Advice:advice@ffppc ca:gov(866/275-3772)
www.fppc.ca.gov
Q
Statement of Organi%ation A • -
Recipient Committee • - 8
INSTRUCTIONS ON REVERSE -
Pop 3'
COM MITTEE NAIdE I.O.NUMBER.
Tony Brandenburg for Encinitas City Council 2018. . 1409435
4
Gqneroi Purpose committee, Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ BOUNTY Committee ❑STATE Committee
PROVIDE GRIEF DESCRIPTION OF ACTIVITY -
List additional sponsors on an attachment.
NAME OF SPONSOR JINDUSTAY GROUP OR AFFILIATION OF SPONSOR
STREETADDRESS NO.AND STREET - CITY STATE ZIP CODE AREA CODE/PHONE
❑
Date qualified
y g g °y` th '; e / p ; " p p h fy, allofihe:foilowlpgcontlitionshq been met
5 Termination Requirements B si ni the etificatton, e treasurer asslstantSreasureEand or andid to officeholder pr Toone EcerN that
_. r .r _. .F ;. .0
• 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(August/2018)
FPPC Advice:advice @fppc.caagov(866/275-3772)
www:fpPC:ca.gov