HomeMy WebLinkAboutForm 410 - Mahmoud A. Shirazi; Statet
Statement of Organization L
Recipient Committee
Statement Type IvInitial
RECEIVE tate
in ffice ofthe D ANDrFILsED
of the State of Camornia
AUG 2 7 202
❑ Amendment ❑ Termination — See Part rn
O Not yet qualified
or
Date qualification threshold met Date qualification threshold met
I.D. Number
NAME OF COMMITTEE
OF C�dy ITWIMLrAAIR4� LI(TIJ�Jki
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STREET ADDRESS (NO P.O. BOX)
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CITY ,f7 STATE ZIP CODE /^A EA ODE/PHONE
FULL MAIIJ INNG ADDRESS (IF DIFFERENT) ,�f n n ,v��'-j r (j y'�, f(„% VA
COUNTY OF DOMICILE � 1l�IS�ON—WHERF L_nMMIT TEE 15 ACTIVE
Attach additional information on appropriately labeled continuation sheets
Date of termination
Date Stamp , I I lei 1 �1 I,
CEIVED
e office of the Secretary c
Of the State of Californ
AUG 13 2024 1 U 41 7' 1 -7 202
TREASU2ER
CI �N% F4�� TE E/90/
NAVJE OF ASSISTANT TREASURER, IF ANY
S rREET ADDRESS (NO P.O. BOX) CITY
XIL ADDRESS OF ASSISTANT TREASURER (REQUIRED)
i/�
NAME F PRINCIPAL IC (S) r
.AREA CODE/PHONE
STATE ZIP CODE
AREA CODE/PHONE
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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. e foregoing is true and correct.
Executed on
ATE SIGNATURE OF TREASURER OR
PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR SPATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (October/2023)
FPPC Advice: advicefp_p.c.ca,gov_.(866/275-3772)
www fppc_c_.a,gov
Statement of Organization ,
Recipient Committee
INSTRUCTIONS ON REVERSE
Page 2
I.D. NUMBER
COMMITTEENAMEy A-.rl—�%%� Zi -
All committees must list the financial institution where the campaign bank account is located and the person(s) authorized to obtain bank records.
OF FINANCIAL INSTITUTION AND PERSON(S) AU HORIZED TO OBTAIN BANK RECORDS AREA CODE/PHONE BANK ACCOUNT NUMBER
ADDRESS OF FINANCIAL INSTITUTION CIS ✓i S TE ZIP C
.� 73 iG'c.✓�'`1 C �. Ctrs/` J ),&_ tt � � q qqi q
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• 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
NI—Ar nr rAmninATFinFcir ri-4nl CFR/STATF MFASURE PROPONENT (imCI Ifni, nISTRICT NHMBFR IF APPLICABLE) ELECTION CHECK ONE
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Nonpartisan
Partisan
(list political part
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Nonpartisan
Partisan
(list political party below)
Primarily formed to 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)
IF A RFFAI I CTATF "RFCAI I" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
SUPPOR"r OPPOSE
SUPPORT OPPOSE
FPPC Form 410 (October/2023)
FPPC Advice: advice@-fgpc.ca.gov (866/275-3772)
www.fppc.ca.gov
