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410 Pearce CC W7 (03-07-19)_R
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City Clerk
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Statement of Organization <br />Recipient Committee <br />INSTRUCTIONS ON REVERSE <br />COMMITTEE NAME <br />Dr- f.J ; L(t u^, F'er-Le Pth- 2.0l`k <br />• All committees must list the financial institution where the campaign bank account is located. <br />NAME OF FINANCIAL INSTITUTION <br />50o15FGt4- <br />BANK ACCOUNT NUMBER <br />ADDRESS <br />CITY <br />STATE <br />CA- <br />ZIP CODE <br />4. Type of Committee Complete the applicable sections. <br />Controlled Committee <br />• 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 <br />district number, if any, and the year of the election. <br />• List the political party with which each officeholder or candidate is affiliated or check "nonpartisan." Stating "No party preference" is acceptable. <br />• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. <br />NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT <br />ELECTIVE OFFICE SOUGHT OR HELD <br />(INCLUDE DISTRICT NUMBER IF APPLICABLE) <br />YEAR OF <br />ELECTION <br />PARTY <br />CHECK ONE <br />\ A-0 <br />� . <br />L 7 C, --Fit comic,: i--Crt74 f.. a. <br />2ota <br />Nonpartisan <br />Partisan <br />(list political party below) <br />X <br />SUPPORT <br />Nonpartisan <br />Partisan <br />(list political party below) <br />Primarily Formed Committee <br />Primarily formed to support or oppose specific candidates or measures in a single election. List below: <br />CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) <br />IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. <br />CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION <br />(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) <br />CHECK ONE <br />FPPC Form 410 (August/2018) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />SUPPORT <br />OPPOSE <br />SUPPORT <br />OPPO <br />FPPC Form 410 (August/2018) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />
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