410 Number assigned ~3
Statement of Organization
Recipient Committee
Type or print in ink ~~~SC-'~
Statement Type initial ^ Amendment
Not yet qualified ^ or List I.D. number:
Date qualified as committee Date qualified as committee
(If applicable)
^ Termination -See Part 5
List I.D. number:
/~
Date of Termination
1. Committee Information
2.
NAME OF COMMITTEE
~~~r2 y GN/~~1~ k2 coc.c,cl~',~L .Y~o ~'
STREETADDR SS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
~p~R-r~~c1U ~ C~ 9~~~ ~~s)6~~-63~?>~
MAILING ADDRESS (IF DIFFERENT
STATEMENT OF ORGANIZATION
I ~ tt a State o Calrforyrn~ ~
For
SEP 212009
DEBRp- Bo St to
Secretary
Treasurer and Other Principal Officers
NAME OF TREASURER
`J Gt is C-1-~f~1.j~-~
STREET ADDRESS (NO P,O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
C-w~E'~' 7"21.1 ~ ,, C' /~ g~ ~ ~ f~c~~-6 ~d~- 6j 9~
NAMEOFA SISTANTTREASUREf2,IFANY
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
~ys U~) ~' 9~ ' ~ / (j U hG~ Y/i 4 ~' Z• Q Y~,'i'yt ~ @ . f•..n; .Q ~AME OF PRINCIPAL OFFICER(S)
COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE STREET ADDRESS (NO P.O. BOX)
S~iJ7,~ C !-~ IZ ~
Attach additional information on appropriately labeled continuation sheets.
CITY STATE ZIP CODE AREA CODE/PHONE
3. Verification
I have used all reasonable diligence in preparing this statement and to the best of
OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
tatement of Organization STATEMENT OF ORGANIZATION
Recipient Committee _' ' ~ 1
INSTRUCTIONS ON REVERSE
Page 2
BIB ~ ~/ C NHS ~ (~ ~ ~ c~ u,Jc s L- 2 ~ o
4. Type of Committee Complete the applicable sections.
• 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.
• List the political party with which each officeholder or candidate is affiliated or check "non-partisan."
• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
ELECTIVE OFFICE SOUGHT OR HELD
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
~' /b /~ ~ ~ C ~~,~--1,1 G
G(,~ - 2~cJ C~ C r ~ C~ u~c/ cz
~d ~ ^ Non-Partisan
~G~~l v C%~',~ 7"
^ Non-Partisan
• List the financial institution where the campaign bank account is located (controlled "candidate election" committees only)
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANKACCOUNTNUMBER
~-~?~ of ,~-,fn ~2 , ~~ ¢'o~~ 7~~ - 3 ~ ? 4 G ~ 3 - 7~ ~ / o
ADDRESS CITY STATE ZIP CODE
Z o S" 6 3 ~ T~ ~'~NS cnt ~~ ~L ~ . Gc~~~i~TsrJ~ , C ,~- 9 s-a i fC'
• . Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE
FPPC Form 410 (June/09)
FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772)