HomeMy WebLinkAbout2019-05-30 Form 410 - PettitStatement of Organization Oate Stamp ' ,. . .. . ' " -·~ ........ ·~~--.. ' .
Recipient Commi!tee ,--7"------------,------------y-------------1 Statement Type I] Initial D Amendment D Termination -See Part 5
CALIFORNIA 41 Q
FORM .
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0 Date qualification threshold met Date qualification threshold m et
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1. Committee Information
N AME OF COM MITTEE
I.D. Number
(if applicable)
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2019 Lt,Y 30 Pi1 2: 08
Date of termination
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2. Treasurer and Other Principal Officers
/'. ,ME OF TR EA SURER.Iv)~ ) I. -
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I" " '. \ D . ..)\ ., L \ 3 2.L:.ic-1 ST REET ADDRESS (NO P.O. BOX) ~ l ~, t
STREC T ADDRESS (NO PO BOXI OTY
N AM E OF
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ZIP CODE AREA CODE/PHON E
ZIP CODE A REA CODE/PHON E
I have used all reasonab le diligence in preparing this statement and to the bes t of my kno
penalty of perjury under the laws of the State of California th e for
information contained herein i s true and complete. I certify under
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Execu t ed on
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c:i!ITE
Execu t ed o n
DATE
Executed on
D ATE
By
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s1G NATURE OF CONTROLLING OFFICEHOLDER, CA NDIDATE. OR STATE MCASURE PROPO NENT
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FPPC Form 410 (Au gust/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
-~
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Page2
All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION ,,,...-
I ,Ue,ll-S f7!rRG 6
AREA CODE/PHONE BANK ACCOUNT NUMBER
P£JUditJ.h
ADDRESS STATE ZIP CODE
f!'. Typ_e of ,G.lfil1f11itt!le ·:temple~~ th~·appiic~l:ile sectio~s'.' ;,, '· ,,
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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.
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE)
YEAR OF
ELECTION
PARTY
CHECK ONE
Partisan (list political party below) • Nonpartisan Partisan (list political party below)
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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)
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
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CANDIDATE(S) OFFICE SOUGHT OR HELO OR MEASURE{S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
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FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
0 CITY Committee O COUNTY Committee O 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 ZlPCODE AREA CODE/PHONE
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oate quallfiecl
5 .'. Ter.rni n·ati<>n · ~~-~ "ui re m~-ri~s :.;-~-f;•i<; sv ,s_1go1 ng)~e y"erificapop,J~~' i_i:_~~su rer, _ as~i~an~. tr~a:s_~rer ~':!~/Q(9irid~ate, offic~holder, ,o'f proP,O~~nr~~rtjfy:;h~~ ~!I~ of.the. t6j1o~·ipg. con'ctfri9QS-~~~~ ·be_~n ·m~et::J' "::-.i :: :~ "; j
• 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.ca.gov (866/275-3772)
www.fppc.ca.gov