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HomeMy WebLinkAboutForm 410 - Mahmoud A. Shirazi; State 1RECEIVED AND FILED in the:office of the Secretary of State Stafernert of Organization JUL 28 2025 D nn UateSlaEmp ReOpient Comrnittee CALIFORNIA nitial ❑ Amendment j� ,i Statement Typer(0)Nol ❑ Termination art 2024 •- For official Use or~ly yet qualified or � C� Uato qualiFication threshold met Date qualification threshold met �jp�_ Date of ter Oat ff LERK'S OFFICE • • Ian. Number 2, Treasurer and Other • alf • fficers- � ?n i e plfcvble NAML OF COMIAI 1111 NAME OF TREA5URER CLERK'S OFFS A !== *F. - STREET ADDS ESS IN P,O. aDX) ,- �. c�¢t�.r �7'�C_ STATE �„i� 211P COD' AREA CODE/PHONE ��� �` STATE ZIP CODE AREA CODE/PHONE " A ?q 10 ' NAME OF ASSISTANT TREASURER, IF ANY FULL MAiUNO ADDRESS !IF DIFFENENT) � . t ! STREET ADDRESS INO P.O. BOX) r dylA I A DURe55(t I:Ou1 RE 0) 1 fAX 10 PTIONA LI CITY STATE ZIP CODE AREA CODE/PHONE COurl i/Y Or DOMICILE JURISDICTION WHERE COMMITTEE is ACTIVE NAME OF PRINCIPAL OFFICER(S) STREET - ADDRESS tNO P.O. 1109) TTREEETT,-� ZIP CODE AREA CODE/PIIOPIE It have used all reasonahie diiiAranrF, in nrt n—i— Laic L . -- -- -••-• __ — �_ _It, .„ penalty of perjury�aund r th+�fe laws of the ORSTATE MEASURE PROPONENT Gxec:L ted on By DATE SIGNATURE OF CONTROLLING OFFICEIIOLDER,CANDIDATE, OR STATE MEASURE PROPONENT Execu[ed on By unrL SIGNATURE OF CONTROLLINGOFFICEHOLDER, CANDIDATE, OR 5TATE MEASURE PROPONENT FPPC Form 410 (August/2018) FPPC Advice: advice2fl?PC.Ca.9ov (866/275-3772) Ivww.fu c.ca.gp_v Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE WNW] I [El NAME 1'2 xS ,lam e- —z,t All committees must list the financial institution where the campaign bank account Is located. HA" OF FINANCIALINSTITUTiON AREA CODE/PHONE ADDRESSimp Page 2 LD. NU41ABER 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. ;F 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 OF CANDIDATE/OFEICEHOLDERJSTATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY CHECK ONE ® Primarily formed to support or oppose specific candidates or measures in a single election. List below; CAINDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(.;) 1URISnICTION IF A RECALL, STAT"E "RECALL' IN FRUN I OF I HE eWrIf FNn1 nca,c nlnnnc CHECK SUYP0 R TT ONE OPPOSE SUPPORT DPPDSE' FPPC Form 410 (ADgust/2018) FPPC Advice: advice _tRPS.ca.ROV (866/275-37721 www.fPPS.ca RUv