HomeMy WebLinkAbout2019-06-21 Form 410 - PettitJ
rJ A r'J. ~ ~t-_,,,. Statement of Orpniutlon .·
RGClplentOommittu .. .· Rff:E!VEO AND FILE. · ·. -, ---.----~ ·· office-Ofthe~etffiotstam
Statement Type 10 lmtlal lo Aml>Cdment lo T-,mal!Qft -See p,J\' ~ Oil~><! S!ete ;,f Califq,-nia · ..
Nol yet qualilled
"' ,Q !late ~flca!lon 1lm>Shold met I !late quaiffiaa!lon m,.,.hoo:I met
-,--t. ........ l~
1.0.. Number . ..· . · ·
ti/ aP,1/11:i,J)/(,J Req~
'.fAAMJi:twC,.gfJM!Utr. . . . ]\.
Allie f'eliit forCity Council, !Jistrict 3, 2019 . Miehai;I. Mceul!C!¢h •
&.
1,litf!-@rm-ii::fNt
-----------,a,,".,."· ',u"m"r"o","ro°",mw;.""'"'u""".,.'"""'""ir".,"·o,"oc°"'"''""""''··',",,..""',"r"o",","r,".r",'M","•"su","<"•""°"·"'""""'"""',----------ffl'C form 4l0 {Alll!U,t/2016!
fl'l'C A<M«: ad!lif~@f PP<,a,11""1$66J21S.3ml . . . . www.fi>pc .... p
Statement of Organization
Recipient Committee
CALIFORNIA 41 Q
FORM
INSTRUCTIONS ON REVERSE
Page
COMMITTEE NAME LO, NUMBER
Alfie Pettit for City Council, District 3, 2019 Requesting
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAUNSTfTUTION
AOORESS CnY STATE ZIP CODE
-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 "nonp-artisan:" Stating "No party-preference" is acceptable.
• If this committee acts jointly with another controlled committee, list the n·ame and identification number of the other controlled committee.
NAME OF CANDIDATE/OFFJCCHOLOER/STATE MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELD
(lNClUD_E DISTRICT NUMB.ER IF APPLICABLE)
YEAR OF
ELECTION
PARTY
CHECK ONE
Nonpartisan
Alan P Pettit Councilmember, Palm Springs, District 3 2019 El
. Nonpartisan •
Pnmarify Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDAiE{S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR-LETTER)
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATE(S) OFFICE SOUGHT OR HELO OR MEASURE{S)JUR!SO!CTION
(INCLUDE DISTRICT l\ilO., CITY OR COUNTY, AS APPLICABLE)
Partisan • Partisan n
(list political party below)
..
.
(list political party below)
CHECK ONE
b[j
n".·I •
.
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
COMMITTEE NAME
Alfie Pettit for City Council, District 3, 2019
pii~
General Purpose Committee 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
Sponsored Committee list additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO. AND STREET '"" STATE Z!P CODE AREA CODE/PHONE
Small Contributor Committee •--1--t
Date qualffied
• 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 surp(us campaign funds h
0
eld by elected officers who are· leaving office and by_defeated cindidates. ·Refet to Government
Code Section 89519. ·
Leftover fund_s 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