HomeMy WebLinkAboutForm 410 - Natu Tuatagaloa for Board of Education 2018 InitialStatement of Organization
Recipient Commi tee
Statement Type Initial
0 Not yet qualified
or
0 Date qualified as committee
❑ Amendment ❑ Termination — See Part 51 p i A U G 9 2018
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/ / / / ► IiY CLERK'S OFFI
Date qualified as committee Date of termination
I.D. Number
(if applicable)
NAME OF COMMITTEE ^
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STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
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MAILING ADDRESS (IF DIFFERENT)
E`-MAAIILL�
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE 15 ACTIVE
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Attach additional information on appropriately labeled continuation sheets.
I have used all reasonable diligence in preparing this statement
penalty of perjury) under the. laws of the State of California t
Executed on gig l 20 ( 8 By
I DATE
Executed on gl g { ZO 1 $ By
DATE
Executed on
DATE
Executed on
DATE
NAME OF TREASURER
For Official Use Only
STREET ADDRESS (NO P.O. !OX)
CITY STATE ZIP CODE AREA CODE/PHONE
Jprr.! (RAf%�l, C � a4 vo I
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF PRINCIPAL OFFICER(S)
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STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
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and to the best of my knowledge
the foregoing is true and correct.
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SIGNATUR OF EAS RER OR
SIGNATURE OF CONTROLLING OFFICEHOI DER Ar
rmation contained herein is true and
OR STATE MEASURE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
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FPPC Form 410 (February/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA'
Recipient Committee • -
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME
I.D. NUMBER
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
ADDRESS
BANK ACCOUNT NUMBER
CITY STATE ZIP CODE
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re'•i .�.. �%..::.: b..::.., ;. - �:�., .,.• : i:+s: `Y ,�I.e '#3+�.2=;:kt•"KI` �4kKIiCr��a '�-i'���nY` 99��?L�:C� ' ku=:: �-
• 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.
ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
�tt n 2Oi n
►�1Q�J 1 �c1 P�c(rar L U
*eU &� o r�
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No arts n
Partisan
❑
(list political party below)
❑
❑
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) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
IFA RECALL, STATE "RECALL" IN FRONT OFTHE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) rucry nuc
FPPC Form 410 (February/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
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SUPPORT
OPPOSE
❑
❑
SUPPORT
❑
OPPOSE
❑
FPPC Form 410 (February/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
J
Statement of Organization CALIFORNIA'
Recipient Committee • -
INSTRUCTIONS ON REVERSE
Page 3
COMMITTEE NAME I.D. NUMBER
General Purpose Commiffee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee ❑ Political Party/Central Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREETADDRESS NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE
Date qualified
• 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 maybe 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 (February/2018)
Clear Page Print �� FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov