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Home My WebLink AboutPerry Woodward - Form 410 - 2012 InitialStatement of Organization Recipient Committee Statement Type Initial Not yet qualified ❑ or 71 )8/ C2- Date qualified as committee Committee Information STATEMENT OF ORGANIZATION Type or print in ink Date Stamp CALIFORNIA O. ❑ Amendment El J Termination — See Part 5 UL 2012 For Official Use List I.D. number: List I.D. number. f CLERKS C�• , # # _I If __l— I Date qualified as committee Date of Termination (If applicable) NAME OF COMMITTEE COM• -4 / WJ 4 V 6--c:1 Grit Z STREETADDRESS (NO P.O. BOX) 72,141 4CAq tf IQ6(Sc 0� • - 2. Treasurer and Other Principal Officers NAME OF TREASURER CITY STATE ZIP CODE AREA CODE /PHONE G.' /roy CA rr'fbZo �a$- 891-92 °`f MAILING ADDRESS (IF DIFFERENT) OPTIONAL: FAX/ E -MAIL ADDRESS fos0olwA'de #'.ra - A", eon COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF ulrrEKEN I THAN COUNTY OF DOMICILE Attach additional information on appropriately labeled continuation sheets. .lk fit/. Gae d STREET ADDRESS (NO P.O. BOX) 756 Lc Ca v+- CITY STATE ZIP CODE AREA CODE /PHONE C- -- Ffb2 -o q6 `SY2-TO3.5 NAME OF ASSISTANT TREASURER, IF ANY �L rid/ �oea✓o✓a rr% _.. - 72--tt tog rc /�df ��• CITY STATE ZIP CODE AREA CODE /PHONE C,- ftai-0 Wy - "/- 26f NAME OF PRINCIPAL OFFICER(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 27W perjury under the laws of the tate f California that the foregoing is true and correct. Executed on / 1 V ` By ATE Executed on —711 o (i y B DATE /,,,SIGNATURE OF contained herein is true and complete. I certify under penalty of 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 (April /2011) FPPC Toll -Free Helpline: 8661ASK -FPPC (8661275 -3772) Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE STATEMENT OF ORGANIZATION COMMITTEE NAME I I.D. NUMBER 4 �o,•� •� •mac fir«+ wood�.�o( �, ce �� .�1 2�� 2- P e.-jd- 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 I Jt MG S �l%ao�wa /U Ceu�G�� /Nc�.�c..i 2 Q' 2 x Non- Partisan ❑ Non - Partisan • List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION AREA CODE /PHONE BANK ACCOUNT NUMBER we-115 fA /�o q0$ -277- GS 3 5 962-1 Z C171 ? I ADDRESS CITY STATE ZIP CODE 1 2 Lc„A c l At Z_o._ S+N -1 �S G 1-51�'2. 75-11 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 OPPOSE FPPC Form 410 (April /2011) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE 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 List additional sponsors on an attachment. NAME OF SPONSOR STREETADDRESS CITY INDUSTRY GROUP OR AFFILIATION OF SPONSOR STATE ZIP CUDE STATEMENT OF ORGANIZATION Page 3 I.D. NU N -� 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. FPPC Form 410 (Apri1 12011) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Statement of Organization Recipient Committee Statement Type Initial Not yet qualified ❑ or 7 t 1$J 12 Date qualified as committee 1. Committee Information Type or print in ink ❑ Amendment ❑ Termination — See Part 5 List I.D. number: List I.D. number: Date qualified as committee Date of Termination (If applicable) NAME OF COMMITTEE /�/ Ir�MM 44,11- —4 /C 4- STREET ADDRESS (NO P.O. BOX) 7 2 W a7 4 IQ o(51 19"' CITY STATE ZIP CODE AREA CODE /PHONE G tray �� sa2a g(s- sg� -9za`t MAILING ADDRESS (IF DIFFERENT) OPTIONAL: FAX/ E -MAIL ADDRESS Pwe0ofW^ d 0 *e ova — A&J . COrti COUNTY STATEMENT OF ORGANIZATION Date Stamp RECEIVED AND CALIFORNIA in the office of the Secret of the State of Cali rnia For Official Use Only JUL 19 201 DEBRA 130 EN Secretary of ;ate Z. Treasurer and Other Principal Officers NAME OF TREASURER A Ik Gy, coo c/ STREET ADDRESS (NO P.O. BOX) 76a 1.c. P- G CITY STATE ZIP CODE AREA CODE /PHONE C/7 ffZ Zo q6t - $Y2° -5,o33 NAME OF ASSISTANT TREASURER, IF ANY CT�CCT AnnO CC /AIl1 nl1 nr1v J CITY STATE ZIP CODE AREA CODE /PHONE c< NAME OF PRINCIPAL OFFICER(S) COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE STREET ADDRESS (NO P.O. BOX) Attach additional information on appropriately labeled continuation sheets. 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 kno edge theinn ti perjury under the laws of tthhe /tate f California that the foregoing is true and correct. Executed on / / / 12— By --7 / SIGN Executed on ` 1 If / �' g � --- OAT /,/SIGNATURE OF CONTF contained herein is true and complete. I certify under penalty of Executed on AT gy DE 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 (April /2011) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE 1.,,....,n, -� . CD.N,wt • i'f c t 4b &'c c-+ �it%adr,J e/or -4 �o c..vc .� � tot -2 STATEMENT OF ORGANIZATION I.D. NUMBER P 4. Type of Committee Complete the applicable sections. Controlled iCommittee I • 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. NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD ) (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY ?C�'! JJ MG WW S v.-rd 2 o l 2 Non- Partisan ❑ Non Partisan • List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) IV ivic yr r1NANCIAL INJ I I I U I ION Weel1s r"ktr F -wk AUURE55 /2.1 PQ .1k 6w4c_ 1 P/4 2.a_ AREA CODE /PHONE J03-277- CS-35 CITY S,N 30s BANK ACCOUNT NUMBER $02I _CI?? /9q STATE ZIP CODE CA l2 F-r /! 3 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 FPPC Form 410 (April /2011) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)