410 Statement of Organization - Amendment reassigning committeeik%
Statement of Organization
Recipient Committee
Statement Type ❑ initial
Not yet qualified ❑ or
Date qualified as committee
COPY
1j Amendment
List LD. number:
Date qualified as committee
(If applicable)
El Termination Termination —See Part S in the
I.D. number:
Date of Termination
Date Stamp
;QED AND FILED
ice Of the Secretary of State
'the State of Caii%rrria
JUL; 21 2014
Fqf iclL9 ! ly
JU L 2 9 2014
1. Com mittee Infermahon 2. Treasurer and Other Principal Officers
a '
NAME OF COMMCTTEE NAME OF TREASURER
STREET ADDRESS (A() p,O. B�OX] �
CETY
e
I
STAE ADDRESS O P.O. BOX) � e
NAME OF PRI CIPAL OFFICER(S)
STREET ADDRESS (9fO P.O. BOX)
/
USeC[ P P ::.:
I have of perjury Ia under thdiligence laws of the e to of Cali statement and to the best of my knowledge the information contained herein is true and complete. I certify under
penalty California that the foregoing 's true and correct.
Executed on _ _ 7-17-IV, By
GE SIGNATURE (]FT EASURER OR AS N
SISTAT
i1 TREASURER
Executed on 7 T --�Of, I BY
DATE
SIGNATURE OF CO LUNG OFFICEHOLDER, 0IDATE,UR5TATEMEASUREPROPONENT
Executed on f r iI v BY
DATE SIGNATURE OF -
Executed on
DATE
BY
C4 K.
SIGNATURE OF CONTROLLING 0 FEICEHO LD ER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (Dec/2012)
FPPC Advice: advice @fppc.ca.gov (8661275 -3772)
ww%vJppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
c- r–L-
• All committees mist list the financial institution where the campaign bank account is located.
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AREA COVE /PHONE
AVOAE55 CITY STATE TIP CODE
Type of COMM, ittee complete the applicable sections.
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-- ...
_. _.. .......
Page 2
I.D. NUMBER
• 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-
* Listthe political party with which each officeholder or candidate is affiliated or check "nonpartisan."
• if this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELD
iINCLHnF DISTRICT NI Inn Rr:n rr AoDI rr— o VCA V nc r:l er -r,n.r
Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANEUDATE(S) NAMFOR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER)
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURF(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
SUPPORT I oPPOSE
SUPPORT
❑ I ')M
FPPC Form 410 (Dec /2012)
FPPC Advice: advice @fppc.ca.gov (8661275 -3772)
www.fppc.ca.gov