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Statement of Organization <br />Recipient Committee <br />Statement Type <br />❑ Initial <br />Not yet qualified <br />or <br />0 Date qualification threshold met <br />1. Committee Information <br />NAME OF COMMITTEE <br />0 Amendment <br />Date qualification threshold met <br />I.D. Number <br />(if applicable) <br />Q0 F <br />( . C-c-Azric.s L L Li) OJ\.c' <br />0 Termination — See Part 5 <br />Date of termination <br />STREET ADDRESS (NO P.O. 80X) <br />CITY <br />�l.t1E%SI� C <br />/ / <br />Treasurer and; Other Principal Officers <br />NAME OF TREA <br />( <br />STREET ADDRESS (NO P.O. Bt(X) <br />CITY <br />STATE ZIP CODE AREA CODE/PHONE <br />STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY <br />FULL MAILING ADDRESS (IF DIFFERENT) <br />E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL) <br />COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE <br />�tUE'S1bE <br />- ktitl`c'SibE P CA <br />Attach additional information on appropriately labeled continuation sheets. <br />3. Verification <br />1 have used all reasonable diligence in preparing this s <br />penalty of perjury under the laws of the State of Calif <br />STREET ADDRESS (NO P.O. BOX) <br />CITY <br />STATE <br />ZIP CODE AREA CODE/PHONE <br />NAME OF PRINCIPAL OFFICERS) <br />STREET ADDRESS (NO P.O. BOX) <br />CITY <br />STATE ZIP CODE <br />AREA CODE/PHONE <br />Executed on <br />Executed on �` ' ( µ' e By <br />DATE <br />41' <br />DATE <br />By J` <br />on contained herein is true and complete. I certify under <br />R OR ASSISTANT TREASURER <br />SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT <br />Executed on By <br />SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT <br />DATE <br />Executed on By <br />DATE <br />SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT <br />FPPC Form 410 (August/2018) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />