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HomeMy WebLinkAboutForm 410 - San Rafael Public Library Foundation (501(c)(3));Staterk RECEIVED AND FILED in the office of the Secretary of State of the State of California 15 2024 Statement of Organization Recipient Committee Statement Type ® Initial ❑, Amendment 0 Not yet qualified or 0 Date qualification threshold met Date qualification threshold met U1 / G� LUZL I.D. Number Termination — See Part 5 Date of termination MAR 7. 6 2024 CITY CLERK'S OFFICE NAME OF COMMITTEE NAME OF TREASURER Re-4�bmr-y- eutdatbn /G©.4-� Charles H Stuckey ARV AA r-tV t_ L � � �� L4,� � �� San Rafael •wAJ PALE L� C C 3' EMAIL ADDRESS OFTREASURER(REQUIRED) STREET ADDRESS (NO PO, BOX) NAME OF ASSISTANT TREASURER, IF ANY CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 STREET ADDRESS(No P.O. BOX) CI FY FULL MAILING ADDRESS (IF DIFFERENT) EMAI L ADDR ESS OF ASSISTANT TREASU RER (REQUIRED) E-MAIL ADDRESS OF COMMITTEE (REQUIRED) / FAX (OPTIONAL) NAME OF PRINCIPAL OFFICER(S) COUNTY OF DOMICILE IURI$DICTION WHERE COMMITTEE IS ACTIVE Gary Ragghianti Marin San Rafael Attach additional information on appropriately labeled continuation sheets. I have used all reasonable diligence in preparing contained herein is true and complete. I certify under Executed on By DATE SIGNATU RE OF CON I ROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATt MEASURE PROPONENT FPPC Form 410 (October/2023) FPPC Advice: a4vice0f0PC.0.Rov (866/275-3772) yfww.fDpc ca.eov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME Page 2 San Rafael Public Library Foundation /��nHrwzLL ,•le,-p ptt_t Fdy Sa 1 (1)(3 1A NUMBER 1 lI� All committees must list the financial institution where the campaign bank account Is located and the person(s) authorized to obtain bank records. NAME OF FINANCIAL INSIRLITION AND PERSONS) AUTHORIZED TO OBTAIN BANK RECORDS Bank of Marin AREA CODE/PHONE BANK ACCOUNT NUMBER Charles Stuckev 415-485-2265 ADDRESS OF FINANCIAL INSTITUTION 1101 Fourth Street O V STATE P CODE San Rafael zl CA 94901901 • 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. NAME OFCANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD YEAR OF (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) FULLTITLE (INCLUDE BALLOT Na OR LETTER) IFARECALL, STATE "RECALL' IN FRONT OF THE OFFICEHOLDER'S NAME. CANDIDATES)OFFICE SOUGHT HELD OR MEASURES)JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) San Rafael Public Libraries & Community Center Initiative Marin County, San Rafael, CA Pant CHECK ONE SUAPOAT OPPOS[ SUP PORT OPPOSE FPPC Form 410 (October/2023) FPPC Advice: AOvic �(DDC ca aov (866/275.3772) L'nNw.f00c.Ca.ROy Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE 'OMMITTEF NAME Page B San Rafael Public Library Foundation 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 BAWF DESCRIPTION OF ACTIVITY S� "FMP11rJ;im rs "-r- TliR— ��Af3i.LC Li it/i�Rt�p n� R��a>?1 List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREETADDRESS NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE • 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 bythe 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. Referto Government Code Section 89519. — Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511- 89518, and are subject to Elections Code Section 18680 and FPPC Regulation 1852L5. S h FPPC Form 410 (October/20M) G (T Z �N f FPPC Advice: advicerafopc ca eav (866/275-3772) To � � ! i 1 �T / �� wVYw.fupC.Ca.eDV D is n�ff LLf3 t Ry� �CAN �"''^��; �I fiy C-7-R, C-1 T Y 0� 1 At, T+t S rE F 1 r+ fir- YR•1� s�LS- r►1u,H,lr•� _T& .