HomeMy WebLinkAbout2016-07-08 Form 410 - NestandeStatement of Organization
Recipient Committee
Statement Type] Initial ❑ Amendment
Nat yet qualified f or List I.D. number:
NAME OF
r7 I
❑ Termination —See Part S
List I.D. number-.
OvI �
—�-1vi?I --mil —I --I-mil
Date qualified as committee Date qualified as committee Date of Termination
(If appIkamel
ET ADDRESS (NO RO, BO)
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PAM ERT. c
2016 JUL s 8 PM 4 ` tp 3 For 0—Mclal Use Only
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NAME OF TREASURER
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STREET ADDRESS
CODEIPHONE
CITY STATE ZIPCOOE AREA CODE/PHONE
NAME OF PRINCIPAL OFFICERIS)
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIPCOOE AREACODE/PHONE
`V�Ci LattjOtl r _ _ _
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 -
on �' gy
DATE
SIGNATURE OF CONTROLLING OFFI HOLD R, CANDIDATE, OR STATE MEASURE PROPONENT
Executed On By
GATE SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
CATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT
FPPC Form 410 (Dec/2012)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc-ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEENNAME l/,]' J(�y f�jf�1 CA
(/7T1 V f-e5 V`Y 'VI�r ('000C L Y D I I.D. NUMBEfl
1
- All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTIRITION AREA CODE/PHONE BANK ACCOUNT HtlMHEA
1 U�l ����
ADDRESS � + CITY STATE
n ZIP CODE
�
a� _1f o#�'ComllRl 8`Calmplet��tFri:aplicahie:seitions: j1Ut I_J._` /lJ(1� } =+ . .ry _ �_.. 73
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 "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 CCANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT 1 (INCLUDE DISTRACT'NUMBER IF APPLICABLE) YEAR OF ELECTTIION PARTY
l V 1 o1 �Q� C f Y ro(MW��'?/l J�Nonpartisan
f i ❑ Nonpartisan
FormedPrimarily Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIOATEfS) NAME OR MEASUREISI FULL TITLE (INCLUDE BALLOT NO. OR LETTER} CANDIDATES) OFFICE SOUGHT OR HELD OR MEASUREIS) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE
St1PPOItT OII
I
S UPP�❑ `..J Oi
FPPC Form 410 (Dec/2012)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
Statement Type ;M Initial
Not yet qualified 9or
NAMEOF
I
MAILING
1�14
FAx / E-MI
Rci]eolod, ._J�
j RECEIVED AND HMO"'!
Inthe I
of State of • -
9 L,R2.22016 �-
❑ Amendment ❑Termination --See Part 5 For ofl[cial use only
List I.D. number. List J.D. number._—
n
Date qualified as committee Date qualified as committee Date of Termination
(Happ6mbla)
de Rr- 67
i J
MHO P.O. BOXI
-�-1 pl ll 1 �l
STATE ZIP CODE
In the of the Secretary of f Kale
rJUolthe Slate of Cafifomie
L;112016
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n
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NAME OF TREASURER — f� M
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E._ / STAEET ADDRESS [NO P.O. ROXI a
��5�'� t"_Q. �`! 3 b' �R tiltyEct`-r���
AREA ODBE/PHOH D CITY STATE ZIP CODE AREACODE%PHONE
•S -;;-:T4&o
NAME OF ASSISTANT TREASURER. IF ANY
aof, Cfm
IS ACTIVE
STREET ADDRESS INC PC BOX)
CITY STATE ZIPCODE AREA COOE/PHOHE
NAME OF PRINCIPAL OFFICERISi
Attach additional information on a STREET ADDRESS (No P.O. BOXI
f appropriately labeled continuation sheets.
CITY STATE ZIPCODE AREA CODE/PHONE
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 ce une'r
penalty of perjury under the laws of the State o
a ifor ICI th he foregoi is true and correct.
.
'`
C7
Lco
.9
3-
f"n
Executed on ! 74I By
AT
C
•_�
SIGNATURE OF TREASURER OR ASSISTANT MEASURER
Executed
On By
r-n
L
t]
GATE
SIGNATURE OF CONTROLLING bFFI OLD ,CANDIDATE, OR STATE MEASURE PROPONENT
:=—� ..
Executed on By
C --
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
UAIL
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (Dec/20121
FPPC Advice: advice@fppc.ra.gov (866/275-3772)
www.fppc.ca.gov
Statethent of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
I'.',MMITTEE NAME
r 1 na. N-e'5+60d
• All committees must list the financial institution where the campaign bank account is located.
NAME oFFINANCIAL snrurloN
VJ
ADDRESS iq 105 �L PrA�c:v
AREA CODWRONE BANK
an At AA '1/''�J /JMrh1�I C&
STATE
Page 2
I.D. NUMBER
ZIPLODE 7
7 ZG_6 D
• 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
PrimarilyPrimarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATEW NAME OR MEASURE{SI FULL TITLE (INCLUDE BALLOT NOON LETTER)
CANDIDATE(S) OFFICE SOUGHT OR HELD DR MEASUREISI JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
PARTY
CHECK ONE
FPPC Form 410 JDec/2012)
FPPC Advice: advice@fppr.Ea.gev 1866/275-37721
www.fppc.ca.gov