HomeMy WebLinkAboutForm 410 - Randy Warren for City Council 2013 (2013-09-23)Statement of Organization
Recipient Committee
Statement Type 0 initial
Not yet qualified 0 or
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List I.D. number:
D Termination - see Part 5
List I.D. number
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08 06 2013
------ / Date qUalified as committee Date'of Termination
Date qualified as committee (if applirable)
STREET ADDRESS (NO RO. BOX)
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C,VT Y
SAN RAFAEL CA 94903 (
MAILING ADDRESS (IF DIFFERENT)
FAX / E. -MAIL ADDRESS
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AN RAFAEL, MARINI CA
MARIN
Attach additional inforrnation on oppropriately labeled continuation sheets.
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STREET ADDRESS (NO P.O. BOX)
63 EL PAVO REAL CIRCLE
CITY
STATE
S
ZIP CODE
AREA CODWHOW
SAN RAFAEL
CA
94903
(
NAME Of ASSISTANT TRASURER, IF ANY
STREET ADDRIESS (NO R.O. BOX)
CITY
STATE
ZIP COVC
AREA CODE/PlIONE
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NAME OF PRINCIPAL OFFICER(S
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STREF1 ADDRESS (NO P.O. BOX)
CITY
STATE
P CODE
ZIP
AREA CODUPHONE
Executed on DNI'E By SIGNATURE Of CONTROLUNG OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDAI'l, OR SWE MEASURE PROPONENT FPPC Form 410 (Dec/2012)
FPPC Advice: advice C0fpPc.ca.90v (866/275-3772)
www.fppc.ca.gov
a
Statement of organiza ion
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
RANDY WARREN FOR CITY COUNCIL 2013
* All committees must list the financial institution where the campaign bank account is located.
•List the political party with which each officeholder or candidate is affiliated or check "nonpartisan."
If this committee acts jointly with another controlled coma-nittee, list the name and identification number of the other controlled committee.
•
NAME OF CAN DI DATE/OFF ICE HOLDE R/S-I*AI*E MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE)
t%-,"#ITY COUNCIL, CITY OF SAN RAFAEL
109MOMIMHORM,
P ti List below:
ily formed to support or oppose s, ecific candidates or measures in a single elec on
PrImorily Formed Committee MINj Primar
CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER)
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
FPPC Form 410 (Dec/2012)
,xddkv-�vice: advice@fvjtc.ca.gov (866/275-3772)
www.fppc.ca.gov