410 Initial tatement of OrganizatiOnRecipient Committee ~7~,~ Typeorprlntinink /~f~ ~ 7 ~ / OateSmmp ~"~O~O"~'~'O"~,~0..,~O.~ 410
S~ment Type ~lnitial ~ Amendment ~ Te~ination - ~ Pa~ 5 RECEIVED AND FILED
N~ ~ qualifl~ ~ or L~ I.D. num~ Li~ I.D. numar: ~LITIC AL REFORM DIV:
O~ICE O: SECRETARY OF ~',.., :"~
7 ? ZOO1
~ qual~ as ~ D~ qu~ ~ ~ ~ ~ T~
~11 I .l~kl~
1. Commiffee Info~ation 2. Treasurer~~~~m
~E~C~MH ~bE ~E ~ T~URER
10720 ~~K ~
S~E~ ~RE~ (NO RO. ~X) C~ STATE ZIP C~E ~ ~E
10720 ~~K ~ ~~ ~ 95014 (408)725-8939
C~ ~A~ ~PCO~ ~HONE ~E ~ ~SI~T ~URER. IF ~
~~ ~ 95014 (408)725-8939
S~ ~RE~
~LING ~RE~ (IF DIFfer)
125 ~ ~ ~Z~'~'~ SU[~ 1160~ ~ ~ ~ 95113 c~w ~TE aP~DE ~HONE
~L: F~ I E-~IL ~D~
( 408 ) 255-6873 ~E~D ~ITI~ ~O~ER PRINCt~ ~FICER(S). IF ~PLI~LE
~ OF ~ICILE ~UN~ ~ERE ~ ~ ~ bE IS ACTI~ IF DIFFE~
~ ~ ~ ~IClLE ~LI~ ~E~
CI~ ~E ZIP ~E ~ C~HONE
A~ ~i~al in~ ~ a~ ~ ~8~ s~.
3. Verification
I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under penalty of
ExecutedonPerjury under thelaws°fthe State°fCalif°mia thatthe f°reg°ingistrue and correi~~-""~'-'-'"~d------'"Q~&/c-~/'~,,-..P~'P/ By ~)
DATE , SI NATURE OF TREASURER OR SlST~Jhrr TREASURER
FPPC Form 410 (Jan/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC
tatement of Organization .STATEMENT OF ORGANIZATION
Recipient Committee CALIFORNIA410
FORM
INSTRUCTIONS ON REVERSE Page 2
COMMITTEE NAME I.D. NUMBER
DOLLY SANDOVAL FOR SUPERVISOR
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
dJstrk~t number, if any, and the year of the election.
· List the pelitical 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 CANDIDA'rE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
[] Non-Partisan
DOLLY ~AL CT~Y O:XAqCI% (CITY OF ~I'NO) 2001
[] Non-ParlJsan
· List the financial institution where the campaign bank account is located (controlled "candidate election" committees only)
NAME OF FINANCIAL INSTITUTION ~ AREACODE/PHONE BANK ACCOUNT NUMBER
SAN JOSE NATIONAL BANK l[ (408)947-7562 0117109710
ADDRESS CiTY STATE ZIP CODE
ONE NORTH MARKET STt~k-~T SAN JOSE CA 95113
CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BAU.OT NO. OR Lr~ I I ER) CANDIDA'I~E{S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPUCABLE) CHECK ONE
SUPPORT OPPOSE
FPPC Form 410 (Jan/01)
FPPC Toll-Free Helpline: 866/ASK-FPPC