410 Initial
tateme~ of Organization
Recipient Committee
Ill i i II i I
4. Type of Comml~ee cor, N~eee
1 5 200~
STATF..klENT OF ORGN~Q'ATTON
-q
0
· Lisl the, name of each controlling ollloelmldor, candidate, m ~ rm~tlure proponenL It candidate or oflkxl~ddor ~ontrolled, aFao liar t~te e~tlve olll~e sought ~ held, and
d;strk~ numbm, if my, and the year of~ ~lection.
party ~ which each ~cehoKler or canclMate FS alTTIlated m check 'noR-pm'dSan.' '
co~mi~e acts ~o~n(ly w~th en~er ~ontroged co~mltlee, list the nam~ er~J k~e~ number of the other coNmlled =xmwittee.
tIAUE OF CAN (~ATI~YFICEH OLOEIt~TATE UEA3U~I~ PROPGNENT
ELEE:Tk~IE OFRCE SOUGHT OR HELD
(INCLUI~ OIS'FHICT NUMBFR IFAPPLICA:OLI;)
~ OF E~ECllON PARTY
C/~4 ~dDA~E(.S) N~.M£ O1~ ~4E~SUREIS)FULL TITLE ONCLUOE sa ~LLOT NO. OR U=~ ~:~)
· List Ihe Rnancialin~t~l~on where
FPPc Form
FP~C To~F~ Hel~dl~e: