HomeMy WebLinkAboutForm 410- Kate Colin for City Council 2017 AmendmentStatement of Organization
Recipient Committee
CALIFORNIA 410
FORM
Statement Type o Initial
Not yel qualified 0 or
III Amendment
List I.D. number:
o Termination -See Part 5
List I.D. number: APR 2 2 2016
For OIIIdal Use Only
NAME OF COMMmEE
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Dale qualified 8S committee
#1357514
~29 ,2013
Date qualified as committee
(lhpP/lcobiel
Re-Elect Kate Colin for San Rafael City Council 2017
STREET ADDRESS (NO P.O. BOxl
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Date of Terminatfon
NAME OF TREASURER
STREET ADDRESS INO P.O. BOxl
CITY
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER. IF ANY
MAILING ADDRESS (IF DIFFERENn STREET ADDRESS (NO P.O. BOXI
FAXI E·MAILADDRESS CITY
COUNTY OF DOMICILE JURISDICTION WHERE COMMmEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S)
STREET ADDRESS (NO P.O. BOXI
CITY
Attach additional information on appropriately labeled continuation sheets.
STATE ZIP CODE AREA CODE/PHONE
STATE ZIP CODE AREA (DDE/PHONE
STATE ZIP CODE AREA CODE/pHONE
I have used all reasonable diligence in preparing th is statement and to the best of my knowledge the information contained herein is true and complete.
penalty of perjury under the laws of the State-oroalifornia that the fo r,gin g is trJ,le ana correct.
Executed on 04/22/2016 By / C::-4L.Yt.---'£ rk~!...
I certify under
DATE
Executed on 04/2212016
DAT[
By
Executed on
DATE
By
Executed on By
DATE
I L/ ~ _ .--I SIGNATURE OF TREASURER OR ASSISTANT TREASURER
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SIGNATURE OF CONTROlLING OFFICEHOLDER, CANDIDATE. OR STATE MEASURE PROPoNENT
SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE. OR STATE MEASURE PROPoNENT
SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE. OR STATE MEASURE PROPONENT
FPPC Form 410 (Jan/2016)
FPPC Advice: advice(!lfppc.ca.IOv (866/275-3772)
_.fPpc.ca·IOV