HomeMy WebLinkAbout2019-06-26 Form 410 - PettitStatement of Or gan ization
Recipient Committee .--------------.------------..--------------f
Oa te Stamp
CALIFORNIA 41 Q
FORM
State ment Type D Initial '21 Amendment
0 Not yet qualified
or
0 Date qualification thre shold met Date qualification threshold met __ _, ___ , __ _
1. ·Committee lnformatfori: -. ' ,
1.0. Number
{if applicable)
NAME OF CO MM IT rrE
Alfie Pettit for City Council , District 3 , 2019
Attach additional information on appropriately labeled continuation sheet s.
3. Verlfitation""'
D Termination -10\gjof, 2 6 P'1 ~: 3 2 Fo, Officia l use Only
Date or termination _
--1--1--
2. 'Treasurer and Otfie~ Prlf)clpal Officers "
tlAME OF TR£/ISUR£R
Mi chael McCulloch
NAM[ OF A5S1SrANT T~EASURER, IF AN1
N/A
STR[[T AODP.tSS(l,0 PD BOX)
CI IV 5 1/ITE' 71P CODE AR EA (00r/P110Nf
NAME or OfU NCIPAL Of-FICF R{Sl
srREET AOORfSS (NO PO BOX)
CCIV S fATl llP CODE AAl-A COOf/PHON(
I have used al l reasonable diligence in preparing this statemen t and to the best of my knowledge the information con tained herein is true and complete. I certify under
penalty of per jury under the laws of the State of California that the foreg oing is true and co rrect.
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Executed on
DATE
Executed on
DATE
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FPPC Form 410 (August /2018)
FPPC Advice: advice@fppc.ca.go v (866/275-3772)
www.fppc.ca.gov
,,
• Statement of Organization
Recipient Committee
CALIF.ORNIA 41 Q
,FORM
INSTRUCTIONS ON REVERSE
COMMITTEE NAME I.D. NUMBER
Alfie Pettit for City Council, District 3, 2019 1419242
• All committees must list the financial institution where the campaign bank account is located;
NAME OF FINANCIAL INSTITUTION
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." Stating "N~ party prefere~ce" is acceptable.
• If this committee acts jointly with another controlled committee, li~t 1:he name and identification ·nulTlber of the other controlled committee.
t~AM!: OF CANDIDATE/OFFICEHOLDER/STATE' MEASURE PROPONEf'lT ,. 1··
ELECTIVE OFFICE SOUGHT OR HELO
(INCLUDE DISTRICT NUMBER IF APPLICABLE)
YEAR OF
ELECTION
PARTY
CHECK ON(
' Nonpartisan
Alan P Pettit , Cou~cilmember, Palm Springs, District 3 2019 0
Nonpartisan •
Primarily Formed 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)
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATE{S) OFFICE SOUGHT OR HELD OR MEASURE(S) JUR1SDICT10N
(INCLUDE DISTRICT NO,, CITY OR couNrv, AS APPLICABLet
Partisan • Partisan •!
(list political party below)
(list political party be1ow)
FPPC Form 410 (August/2018)
FPPC Advice: advlce@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
CALl_~ORNIA 41 Q
· F.pRM
I.D, NUMBER
1419242
Gene~bN}iJrpose Eomm1tt5!e Not fornied 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
:jpans_ored,Committee List ;additional sponsors on an attachment.
NAME Of SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET ',DDRESS NO. ANO STREIT CITY STATE ZIP CODE AREA CODc/PHONE
,Sf!!dll <;ontributor Committee •-1--1--
oate qualified
~Etrm!ttt~tR1Jtsidt!.ill.~.U~~~¥Y'!fa~~~®~~it!.8Wki~D!~~~~~~~twrBtRf~~!i¥:~~1?$~W~t.~~JV~~tun1:~y§±~l~_its~1ia'~~6m~~~1t:~
• This committee has ceased to receive contributio~s 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, l,oans 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 traniactions.
There are restrictions on the dispositio'n of surplus campaign funds held by elected officers who are leaving office and by defeated-candidates. Refer to Government
Code Secti_on 89519.
leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89S11-89518, 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