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Leroe-Munoz, Peter - Form 410 - 2019 AmendmentStatement of Organization Recipient Committee Statement Type ❑ Initial ®Amendment O Not yet qualified or Q Date qualification threshold met Date qualification threshold met L5 //—/ �Q'U 1. Committee Information I I.D. Number ji 2 —%��% (if applicable) 1 �J / c25 NAME OF COMMITTEE t C'tC'r STREET ADDRESS (NO P.O. BOX) i > MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL) PC.- DOMICILE l.� JURISDICTION WHERE COMMITTEE IS ACTIVE SGI A � CAM r- ,,, (7✓1 1 J Attach additional information on appropriately labeled continuation sheets. Date Stamp RIECEIVED AND FILED I to office of the Secretary of State ❑ Termination —See Part of the State of California Date of termination JUL 29 2019 2. Treasurer and Other Principal Officers NAME OF TREASURER ct -r Lt-i-,x, STREET ADDRESS (NO P.O. BOX) f CITY ( 'IP CODE AREA CODE/PHONE NAME OF PRINCIPAL OFFICER(S) STREET ADDRESS (NO P.O. BOX) CITY STATE LIP 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 al Id complete. I certify under penalty of perjury under the laws of the State - aliftiFn` CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (August/2018) FPPC AdvicE : advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization • ' ' i Recipient Committee,FORM INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME D. NUMBER r \ /� h.11 /I nrrnc;I n o�ta • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER I ?r n ✓I (hL (L lY? vl (� / ADDRESS CITY STATE ZIP CODE S©Zo 4. Type of Committee Cq�n lete the a J -= Yp P Ppli I e ons - lN��uu��Ila�YU�urwhr��� • List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled, also list the el 'ctive 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 accepta')le. • 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 (INCLUDE DISTRICT NUMBER IF APPLICABLE) C, cc,146� �r / YEAR OF PA ,TY ELECTION CHEC ONE Nonpartisan Partisan R-.-, El Nonpartisan Partisan ■.nw•uil.�%,u;iuiiKuuiul;ta'liilr 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) JURISDICTIO I (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) (list political party below) (list political party below) CHECK ONE SUPPORT OPPOSE SU P❑PORT OMPP FPPC Form 410 (August/2018) FPPC AdvicE : advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE CAFORMNIA 410 00MMITTEE NAME D. NUMBER (� � '�l� h r � • t 4. Type of Committee (Continues) General Purpose Committee I Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY '1'ui.ti,JJJ , , 6gglill List additional sponsors on an attachment. NAME OF SPONSOR (INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE Date qualified 5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or cand1datesffu,figlder4 or proponent certify that all of the Wowing 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 can, lidates. 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 (August/2018) FPPC AdvicE : advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee Statement Type ❑ Initial D-"Amendment O Not yet qualified or O Date qualification threshold met Date qualification threshold met 1. Committee Information - I.D. Number (if applicable) NAME OF COMMITTEE R-t--c jel,rUt- - AU-'� %or C,iii CW/\CaI AL-) J�a STREET ADDRESS (NO P.O. BOX) E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL) , COUNTY OFFDOMICILE I JURISDICTION WHERE /COMMITTEE IS ACTIVE (/// v� Attach additional information on appropriately labeled continuation sheets. _Date Stamp U `1 ❑ Termination —See Part J(; �® �l���FRIf;S Date of termination GI�RQi' C4 iff"p Al _ v 2. Treasurer and Other Principal Officers For Official Use Only NAME OF TREASURER 'r� j _ 1 T f-12_< \��(<_Y_ STREET ADDRESS (NO P.O. BOX) I.' ( I STATE PCODE AREACODE/PHONE NAME OF ASSISTANT TREASURER IF ANV STREET ADDRESS (NO P.O. BOX) CITY STATE PCODE AREA CODE/PHONE NAME OF PRINCIPAL OFFICER(S) STREET ADDRESS (NO P.O. BOX) CITY STATE . -P 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 al I I complete. I certify under penalty of perjury under the laws of the State SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (August/2018) FPPC AdvicE : advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME ?+ter i e- r, --e--P0AZr-;r C, 6 (c91A c; i • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE A ria,C-U- Z3 vl Gc, ADDRESS CITY M&A2 rr�"4St-. e)1)f0y9 4. Type of Committee C+plete the applicable sections. BANK ACCOUNT NUMBER STATE ZIP CODE CA- ySpz6 CA11FORNIA, i •- age 2 D. NUMBER • List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled, also list the el ctive 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 accepta �Ie. • 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 f �� I-r 3e - I1 vno ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) Ck- Cc � I�icl I n/%vill h- / YEAR OF PA Y ELECTION CHEC )NE Nonpartisan Partisan Nonpartisan Partisan Formed1 Primarily 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) JURISDICTIO (INCLUDE DISTRICT NO., CITY OR COUNTY AS APPLICABLE) (list political party below) (list political party below) CHECK ONE SUPPORT OPPOSE SUPPORT OPPOSE El FPPC Form 410 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) '.� www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME 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 PROVIDE BRIEF DESCRIPTION OF ACTIVITY ���.+. +•,.,.a.r�t.n+�+ul++ i List additional sponsors on an attachment. NAME OF SPONSOR I INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE Date qualified 'CALIFORNIA • i RM R I age 3 J. NUMBER AREA CODE/PHONE 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 can, I dates. Refer to Government Code Section 89519. -- Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code , ctions 89511- 89518, and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5. FPPC Form 410(August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov