HomeMy WebLinkAboutTerri Aulman - Form 410 - 2012 InitialL`tatomel -A of Orcganizatioz-I
Reci pi,etit cotl3nlittei-
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Not yet qualified 5t or
q3'
Date qualified as committee
1. Cemmittee lntornmti -on
NAME OF COMMITTEE
Type or print in ink
❑ Amendment
List I.D. number:
Date qualified as committee
(If applicable)
/3y3as6
❑ Termination — See Part 5
List I.D. number:
Date of Termination
2.
STREETADDRESS (NO P.O. BOX)
l
Via/ � lA /c.� /`�'' F L, (/.
CITY J STATE ZIP CODE AREA CODE /PHONE
STATEMENT OF ORGANIZATION
-Date Stamp
Tne CEIVED AND FIL
i oofficee Stale ofiCa rfo I of
JUN 2`1 2012
DEBRA BOWE
SetreterY Of $t2
Treasurer and Other Principal Officers
NAME OF TREASURER
STREETADDRESS (NO P.O. BOX) o
--7,09 15- lti� L Cl t
CII(T� STATE ZIP CODE AREA CODE /PHONE
NAME OF ASSISTANT TREASURER, IF ANY
' '' STREETADDRESS (NO P.O. BOX)
MAILING ADDRESS,(W DIFFERENT)
OPTIONAL: FAX /E- MAILADDRESS
CITY STATE ZIP CODE AREA CODE /PHONE
NAME OF PRINCIPAL OFFICER(S)
COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE STREETADDRESS (NO P.O. BOX)
CITY
Attach additional information on appropriately labeled continuation sheets.
STATE ZIP CODE AREACODE /PHONE
�< Verificati,011
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 thef State of California that the foregoing is true and correct.
Executed on 'L < B y
DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER
Executed on r /'7 f !— `�T
DAl L By SIGNATURE CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CON ROLLING OF=FICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (June /09)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
OF ORGANIZATION
COMMITTEE NAME / /.T -�/ I.D. NUMBER
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 "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 CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
® -IVon- Partisan
—1 � 1,� c � GC � / �� 7 T k CL �)
L!/lG� L1 - - -- I
❑ Non - Partisan
A List the financial institution where the campaign bank account is located (controlled "candidate election" committees only)
NAME OF FINANCIAL INSTITUTION REACODE/ /PHONE BANK ACCOUNT.NUMBER
� _ I
ADDRESS CITY STATE ZIP CODE
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
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE
SUPPORT TOPPOSE
OPPOSE
FPPC Form 410 (June /09)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)
Statement of Organization
Recipient (Committee
,Siatenlern# Type
j�'f n itiat
Notyetqualifiied or
_J I
Date qualified as committee
1. Committee Information
NAME OF COMMITTEE /I b+Jt
1
Type or print in ink
❑ Amendment
List I.D. number:
_J I
Date qualified as committee
(If applicable)
❑ Termination — See Part 5
List I.D. number:
Date of Termination
2,
STREETADDRESS (NO P.O. BOX)
CITY
J STATE
ZIP CODE
AREACODE /PHONE
17ve Stamp
JUN 2012...
STATEMENT OF ORGANIZATION
For Official Use
Treasurer and Other Principal Officers
NAME OF TREASURER
ICJ 11 L -
STREETADDRESS (NO P.O. BOX)
'1 t C
CITT,� r STATE ZIP CODE AREACODE /PHONE
NAME OF ASSISA6,NT TREASURER, IF ANY
C' / `' STREETADDRESS (NO P.O. BOX)
MAILING ADDRESS�W DIFFERENT)
OPTIONAL: FAX /E -MAIL ADDRESS
DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE
Attach additional information on appropriately labeled continuation sheets.
CITY STATE ZIP CODE AREA CODE /PHONE
NAME OF PRINCIPAL OFFICER(S)
STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREACODE /PHONE
3. Verif cafton
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. 1 certify under penalty of
perjury under the laws of the State of California that the foregoing is true and correct.
Executed on BYya}iea�s -
DAT t SIGNATURE OF TREASURER OR ASSISTANT TREASURER
Executed on /1 '� By
DATE SIGNA RE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on BY
DATE 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 (June /09)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
Statement of Organization STATEMENT OF ORGANIZATION
Recipient Committee ORM 1
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME 1 T -U I.D. NUMBER
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 "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 CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT AP
(INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
i tc, /1-7 /J
k�,
s .� c,,
G) �2
FL I on- Partisan
J
❑ Non - Partisan
• List the financial institution where the campaign bank account is located (controlled "candidate election" committees only)
NAME OF FINANCIAL INSTITUTION
1
/1EA CODE /PH_ONE nl
BANKAGCOUNT
ADDRESS
CITY
STATE ZIP CODE
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Cyr Q1 �> '— ; � .
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
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE
SUPPORT I OPPOSE
OPPOSE
FPPC Form 410 (June /09)
FPPC Toll -Free Helpline: 866 /ASK FPPC (866/275 -3772)