HomeMy WebLinkAboutForm 410 - Natu Tuatagaloa for Board of Education 2018 FinalStatement of Organization ( L( f O�"`Q Date Stamp WOfffificlal
Recipient CommitteeStatement Type ®initial ❑Amendment ❑Termination— See P I ice of thsANDryILof E Q
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i♦ Not yet qualified of the State of Califomia
Or
O Date qualification threshold met Date qualification threshold met Date of termination AUG 312018
1. Committee Information I.D. Number 2. Treasurer and Other Principal Officers
(if applicable)
NAME OF COMMITTEE NAME OF TREASURER
Natu Tuatagaloa For Board of Education 2018 Judy W. Tuatagaloa
STREET ADDRESS (NO P.O. BOX)
STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE
San Rafael CA 94901
CITY STATE 21P CODE AREA CODE/PHONE
San Rafael CA 94901
FULL MAILING ADDRESS (IF DIFFERENT)
E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL)
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P O. BOX)
CITY
STATE ZIP CODE AREA CODE/PHONE
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEEIS ACTIVE NAME OF PRINCIPAL OFFICERS)
Marin City of San Rafael Natu Tuatagaloa
STREET ADDRESS (NO P.O. BOX)
CITY STATE 21P CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets. San Rafael CA 94901
3._Verification_
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 C ifornia that the f regoin is true and correct.
Executed on 8/26/18 By
DATEy ^ SIGN R OF TREASU SSISTANT TREASURER
Executed on 8/26/18 B / \J\
DATE SIGNATURE OF CONTROLLING OFFICEftLDER,CANDIDATE, OR STATE MEASURE PROPONENT
Executed on I By
DATE
Executed on
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER CANDIDATE, OR STATE MEASURE PROPONENT
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
Page 2
COMMITTEE NAME I,D. NUMBER
Natu Tuatagaloa For Board of Education 2018
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
ADDRESS
4. Type of Committee Complete the applicable sections.
HANK ACCOUNT NUMBER
STATE ZIP CODE
• 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
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATES) NAME OR MEASURES) FU LL TITLE (INCLUDE BALLOT NO. OR LETTER) CAN DIDATE(S) OFFICE SOUGHT OR HELD OR MEASURES) JURISDICTION
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
I"— nu c
SUPPORT
Nonpartisan
Partisan
(list political party below)
Natu Tuatagaloa
San Rafael Board of Education
2018
0
Nonpartisan
Partisan
(list political party below)
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATES) NAME OR MEASURES) FU LL TITLE (INCLUDE BALLOT NO. OR LETTER) CAN DIDATE(S) OFFICE SOUGHT OR HELD OR MEASURES) JURISDICTION
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
I"— nu c
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
SUPPORT
OPPOSE
SUPPORT
Opp05E
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIAi
Recipient Committee • -
INSTRUCTIONS ON REVERSE
Page 3
COMMITTEE NAME I.D. NUMBER
Natu Tuatagaloa For Board of Education 2018
4. Type of Committee (Continued)
CommitteeGeneral Purpose Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ 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 STATF ZIP CODE AREA CODE/PHONE
Small Contributor Committee 11 .1
Date qualified
S. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that all of the following conditions have been met:
• 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 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov