HomeMy WebLinkAboutForm 410 - Natu Tuatagaloa for Board of Education 2018 TerminationStatement of Organization
Recipient Committee [ �%
Statement Type ❑ Initial ❑ Amendment ® Termination — See Pa
0 Not yet qualified JAN 3 1 2019
or
0 Date qualification threshold met Date qualification threshold met Date of termination
12� 31, 201
q1TY CLERK'S OFFICI
1. Committee Information I.D. Number 2. Treasurer and Other Princi al Officers
(if applicable) 1410736 p
NAME OF COMMITTEE
Natu Tuatagaloa For Board Of Education 2018
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
San Rafael CA 94901 (
FULL MAILING ADDRESS (IF DIFFERENT)
San Rafael, CA 94901
E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL)
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
Marin City of San Rafael
Attach additional information on appropriately labeled continuation sheets.
3. Veri cation
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 California that the fore oing i true and correct.
Executed on 12-31-2018 By
DATE IGNAT 0 TREASUR ASSIST NTTREASURER
Executed on 12-31-2018 By
DATE
SIGNATURE OF CONTROLLING OFFICE ER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
NAME OF TREASURER
Judy W. Tuatagaloa
STREETADDRESS(NO P.O. BOX)
For Official Use Only
CITY STATE ZIP CODE AREA CODE/PHONE
San Rafael CA 94901 (
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF PRINCIPAL OFFICER(S)
Natu Tuatagaloa
3i ncc i AUUnt]] (NU P.O. BOX)
CITY STATE ZIP CODE
San Rafael CA 94901
AREA CODE/PHONE
(
Executed on
DATE
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