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HomeMy WebLinkAboutForm 410 - Randy Warren for City Council 2013 (2013-09-23) Amendmentorat+► Organization Recipient C e _.p;: Statement -Type El initial 0 Amendment El Termination — see Part Not yet qualified El or List I.D. number: List LD. flUmber: #1359636 # 63 1662013 1 Date qualified as committee Cate qL] lified as committee Date of Termination (€f applicable) RANDY WARREN FOR CITY COUNCIL 2013 STREET ADDRESS (NO P.O. BOX) CITY STATE CODE AREA CODE/PHONE SAN RAFAEL CA 94963 ( MAILING ADDRESS (IF DIFFERENT) FAX/ E -MAI L ADDRESS INFO@RANDYWARRENFORCITYCOUNCIL.COM COUNTY OP DOMICILE HJURISDICTION WHERE COMMITTEE 1.5 ACTIVF MARIN SAN RAFAEL, MARIN, CA Attach additional information on €tlabeledcontinuation Date Stamp Ru�" 'ter.. .: F° -,4:.x.t �,�a,r, -P - - �x A LU �. �e For t f d vIt� NAME OF TREASURER SIDE ELLEN O'BRIEN STREET ADDRESS (NO P.OBOX) 63 EL PAVO REAL CIRCLE CITY STATE ZIP CODE AREA CODE/PHONE SAN RAFAEL CA 94993 ( NAME OF ASSISTANT TREASURER, IF ANY STREET A€ D CESS (NCS P.O. BOX) CITY STATE "LIP CODE AREA CODE/PHONE NAME OF PRINCIPAL OFFICER(S) STREET ADDRESS (NQ P.O. BOX) CITY STATE ZIP CODE AREA CODE'PHONE Executed onBy L)ATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MCASURE PROPONENT Executed on By DATE SI NAIURL OF CONTROLLING OFFICEHOLDER, CANDIDATC, OR ST[A_'E MF SURE PROPONENT FPPC Form 410 (Dec i.2.) l IUPC Advice: advice fpc.c,ov (866/275-3772) Statement of Organization Recipient i WE INSTRUCTIOI ON REVERSE Page COMMITTEE NAME I.D. NUMBER RANDY WARREN FOR CITY COUNCIL 2013 11359636 * All committees must list the financial institution where the campaign bank account is located. CITY C0UNCIL, CITY OF SAN j A Primarily Orm c o 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) CANT IDATEN OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITE OR COUNTY, , r S APPLICABLE FPPC Form 410 (Dec/2012) FPPC deice: advice ) ppc.c . c (866/275-3772) www.fppc.ca.gov