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HomeMy WebLinkAboutForm 410 - Jon Marker for Board of Education 2018 Initialv� Statement of Organization (V V 768 Recipient Committee Statement Type 'Initial Ili-- ❑ Amendment ❑ Termination — See Part 5 Not yet qualified or Q Date qualified as committee Date qualified as committee Date of termination L, tommlttoe-Wormatio . I.D. Number if applicable) NAME OF COMMITTEE 7701,7 0CCX-*-r--�r -Sou, Cal�tc-a4-W--n % (I? CITY STATE ZIP CODE AREA CODE PHONE Ap&e� MAILING ADDRESS (IF DIFFERENT) ffCEIVED AND FI e Me of the 6dcrl Y n AEVAR F I L e office of the Secretary of of the State of Califomia AUG 07 2d13 2, Treasurer and Other Principal Officers NAME OF TREASURER o STREETADDRE55 NO P.O. BOX For Official Use Only CITY STATE ZIP CODE AREACODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE NAME OF PRINCIPAL OFFICERIS) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach additional information on appropriately labeled continuation sheets. r,r�•x. ,.. . I have used all reasonable diligence in preparing this statement and to best of my knowledge the information contained herein is true and complete. I certify under penalty of perjury u der the laws of the State of Calif i aro!tin!g�istrue and correct. Executed on �� / By D /E IGNA RE OF TREASURER OR ASSISTANT TREASURER Executed on ( By DATE SIGNATURE M CONTROLLING O ICIEHOLDER,CANDIDATE, OR STATE MEASU RE PROPONENT Executed on By DATE Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (February/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization CALIFOA1,11A , 11 Recipient Committee FORM INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME J I.D. NUMBER • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION A EA CODE PHONE BANK ACCOUNT NUMBER ADDRESS �-/STATE ZIP CODE -7vq • 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 �0,7 �� �' nth S� �aG �� Nonpartisan � Partisan ❑ (list political party below) ❑ ❑ SUPPORT ❑ OPPOSE ❑ Nonpartisan Partisan (list political party below) ❑ ❑ Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) NAME OR MEASURE(S) FULLTITLE (INCLUDE BALLOT NO. OR LETTER) IF A RECALL_ STATF "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. CANDIDATEW OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE FPPC Form 410 (February/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SUPPORT OPPOSE ❑ ❑ SUPPORT ❑ OPPOSE ❑ FPPC Form 410 (February/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov