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Dion Bracco - Form 410 Qualified (2018)Statement of Organization Recipient Committee Statement Type El Initial ❑ Amendment Q Not yet qualified or 0-Date qualified as committee / /�- Date qualified as committee 1. Committee Information I.D. Number %�/7(� (if applicable) / `/ t: 6 / �y NAME OF COMMITTEE C�csVL�t� STREET ADDRESS (NO P.O. BOX) �- MAILING A DRESS (IF DIFFERENT) E -MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL) COUNTY OF DOMICILE - JURISDICTION WHERE COMMITTEE 15 ACTIVE S/1 i t'T/9 r( a ✓','- C I( ro c/ C c 2-V Attach additional information on appropriately labeled continuation sheets. Date of termination Date Stamp '.EI ED AND r-119 Office of the Secretary of of the State Of C;alifomin AUG 00 2018 2. Treasurer and Other Principal Officers NAME OF .TREASURER Ett2Q� -e,� '[fir acc,o STREET ADDRESS (NO P.O. BOX) For Official Use Only - V i Or--, Vr'0.0 U-0 STREET ADDRESS (NO P.O. BOX) CITY NAME OF PRINCIPAL ICER(S) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE 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 perjury under the laws of the State of California that the foregoing is true and correct. Executed on g - Ci - Zn (S, By PROPONENT Executed on DATE Executed on DATE By By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410(February /2018) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov C 4,— Statement of Organization CALIFORNIA Recipient Committee - „ INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER �tnh grCC-c_o P6 C�r7'�{ �avnc �' ZG r? -- C� (yO 9L • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE /PHONE BANK ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE Q�J S� r`�T �llrc3y G� 0,2— 4. Type • 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 "nonpartisan." Stating "No party preference" is acceptable. • 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 YEAR OF PARTY NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION Primarily Formed Committee 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 IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY. AS APPLICABLE) SUPPORT Nonpartisan Partisan (list political party below) ❑ fit( ro y EZ ❑ OPPOSE ❑ Nonpartisan Partisan (list political party below) ❑ ❑ Primarily Formed Committee 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 IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY. AS APPLICABLE) FPPC Form 410(February /2018) FPPC Advice: advice @fppc.ca.gov (8661275 -3772) www.fppc.ca.gov SUPPORT OPPOSE ❑ ❑ SUPPORT ❑ OPPOSE ❑ FPPC Form 410(February /2018) FPPC Advice: advice @fppc.ca.gov (8661275 -3772) www.fppc.ca.gov Statement of Organization CALIFORNIA Recipient Committee ; „ INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D. NUMBER scow alr�«d � ��rx Cv�u << l 2� l 8 1��d0. 4. Type of Committee (Continued) Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee ❑ Political Party /Central Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY List additional sponsors on an attachment. NAME OF SPONSOR SIKEEI ADDRESS NU.ANU S KLI,I CITY INDUSTRY GROUP OR AFFILIATION OF SPONSOR STATE ZIP CODE AREA CODE /PHONE t�]IIU IIl4g1N /1.1111�JL4•lll/1I/111%( =� ❑ . Date qualified 5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and /or candidate, officeholder, or proponent certify that all of the following conditions have been met: • This committee has ceased to receive contributions and make expenditures; • This committee does not anticipate receiving contributions or making expenditures in the future; • This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; • This committee has no surplus funds; and • This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government Code Section 89519. Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511- 89518, and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5. Clear Page Print FPPC Form 410 (February /2018) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee Statement Type 'l Initial Q Not yet qualified or (-Date qualified as committee ❑ Amendment ❑ Termination — See Part Date qualified as committee Date of termination Stamp AUG - 6 2018 clr) GILR y �OFFICE 1. Committee Information I I.D. Number j, / � I 2. Treasurer and Other Principal Officers (if applicable) r `T NAME OF COMMITTEE NAME OF TREASURER STREET / STREET ADDRESS (NO P.O. BOX) STREET ADDRESS (NO P.O. BOX) : � MAILING A DRESS(IF DIFFERENT) E -MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL) COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE 15 ACTIVE ry v C Attach additional information on appropriately labeled continuation sheets. - NAME OF ASSISTANT EASURER, IF ANY V i cn--� e1-0.LCo STREET ADDRESS (NO P.O. BOX) NAME OF PRINCIPAL O ICER(S) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE 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 perjury under the laws of the State of California that the foregoing is true and correct. Executed on g — ca — ?1� l91 By MEASURE PROPONENT Executed on By DATE Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (February/2018) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME /� /� I.D. /NUUMMB/E�R/^ i !i v\ Y7'. c r [� F r C i f�f C[ U lz G i 2 G � d ! I `7 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE /PHONE BANK ACCOUNT NUMBER R 0 c �I1\1� `l6_' 1�241 '2- - 1°1,3 t (2)c/i `s(11C� 9y� ADDRESS CITY STATE ZIP CODE � �5— ( 15-1- 1 ; r � �T 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 "nonpartisan." Stating "No party preference" is acceptable. • 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 YEAR OF PARTY NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE Primarily Formed Committee 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) IF A RECALL. STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE SUPPORT Nonpartisan Partisan (list political party below) � ICS U\ � t [ _L (7 �l(i2T r U✓l �G "'i4 � ❑ OPPOSE ;' • ❑ Nonpartisan Partisan (list political party below) ❑ ❑ Primarily Formed Committee 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) IF A RECALL. STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE FPPC Form 410 (February/2018) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov SUPPORT OPPOSE SUPPORT OPPOSE ;' • ❑ ❑ FPPC Form 410 (February/2018) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D. NUMBER 4. Type of Committee (continued) Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee ❑ Political Party /Central Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY List additional sponsors on an attachment. NAME OF SPONSOR STREET ADDRESS NO. AND STREET CITY INDUSTRY GROUP OR AFFILIATION OF SPONSOR STATE ZIP CODE AREA CODE /PHONE l TiiI: 71[ �riTiF ]7lilliiiliQiliiliili�7 -1 =� ❑ - Date qualified 5. Tern!inatlon Requir0m' entS By'slgnirigthe verification, the treasurer, assistant treasurer, and /or candidate, officeholder, or proponent certify that all of the following conditions have been met: • This committee has ceased to receive contributions and make expenditures; • This committee does not anticipate receiving contributions or making expenditures in the future; • This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; • This committee has no surplus funds; and • This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. -- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government Code Section 89519. -- Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511- 89518, and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5. FPPC Form 410 (February/2018) Clear Page: Print FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov