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410 Pearce CC W7 (12-06-19) Termination_R
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Statement of Organization <br />Recipient Committee <br />INSTRUCTIONS ON REVERSE <br />COMMITTEE NAME , b <br />* All committees must list the financial institution where the campaign bank account Is located. <br />NAME OF FINANCIAL INSTITUTION AREA CODt/PHONE <br />Sc'� 0 0 E <br />ADDRESS CITY <br />R � ress fj�— <br />Page 2 <br />I.D.NUMBER <br />1141 <br />STATE Z P CODE <br />CA, W= <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 />TRIVIRMINIpIIIII =11111111ml <br />ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY <br />NAME OF CANDIDATE/OFFICEHOLDERATATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE <br />WIJI(A'r-1 Peo rZZ <br />Reryv�t>,,�k+jve, Wmr4 7 <br />Nonpartisan <br />Fxj <br />Partisan <br />El <br />(list pOIWC;I PaF� belowi <br />–Ro—npa5in <br />PaMsan <br />(list political party G-elowF— <br />i Primarily formed to support or oppose specific candidates or measures in a single election. List below: <br />CAN DIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) <br />IF A RECALL, STATE "RECAW IN FRONT OF THE OFFICEHOLDER'S NAM E. <br />CANDIDATE(S) OFFICE SOUOHT OR HELD OR MEASURE(S) JURISDICTION <br />(INCLUDE DISTRICT NO,, CITY OR COUNTY, As APPLICABLE) <br />FPPC Form 410 (August/2019) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />
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