HomeMy WebLinkAboutPaul Kloecker - 2014 - Form 410 Amendment (March)Statement of Organization
Recipient Committee
Statement Type ❑ Initial
Not yet qualified ❑ or
Date qualified as committee
Type or print in ink
Amendment
Ist I.D. number:
#�311r l20 �
Date qualified as committee
(if applicable)
❑ Termination — See Part 5 IA
List I.D. number:
Date of Termination
I- Committee Information
NAME OF COMMITTEE
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STREET ADDRESS (NO P.O. BOX)
:b 4 75, Dv-,Lrca ��-
CITY STATE ZIP CODE
GkrVCLnti CR. '1i;010
AREA CODE /PHONE
-S%
MAILING ADDRESS (IF DIFFERENT)
OPTIONAL: FAX/ E -MAIL ADDRESS
COUNTY OF DOMICILE
COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE
Attach additional information on appropriately labeled continuation sheets.
LIVED AND FILED
ofe" of the Secretary of State
of the State of CalNtxnta
MAR 1 12014
STATEMENT OF ORGANIZATION
For Officihl Use Only
Malt �p�4 ,
2. Treasurer and Other Principal Officers
NAME OF TREASURER
�o� 0 t_ L V-- %vL ti ti sir
STREET ADDRESS
(P 4. ¢ p
CITY STATE ZIP CODE AREA CODE /PHONE
G ��cz�`c CIA (W 02 o 4 d* - b4813�
NAME OF ASSISTANT TREASURER, IF ANY
2
STREET ADDRESS
CITY STATE ZIP CODE AREA CODE /PHONE
NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE
MAILING ADDRESS
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 krowle
perjury under the laws of the State of California that the foregoing is true and correct.
Executed on �7� /2 �1-`j f
Df TE By x -.
Executed on 2,� 4 / E By
Executed on
DATE
Executed on
DATE
the information contained herein is true and complete. I certify under penalty of
\4.
OF
OR
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
Statement of Organization
Recipient Committee
Statement Type ❑ Initial
Not yet qualified ❑ or
Date qualified as committee
Type or print in ink
Amendment
1st I.D. number:
Date qualified as committee
(If applicable)
❑ Termination — See Part 5
List I.D. number:
Date of Termination
DA11 Stamp
�,pR �p1A
STATEMENT OF ORGANIZATION
For Official Use Only
1. Committee Information
2. Treasurer and Other Principal Officers
NAME OF COMMITTEE
NAME OF TREASURER
7qU L V• kL LOSr- �U4 tt Foe & 1LR0Y
Cli COO N e«
1Z 0 V % L At,
�" �. (Z. V_
ao� a
STREET ADDRESS
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�.Q�►�
STREET ADDRESS (NO P.O. BOX)
CITY
STATE ZIP CODE
AREA CODE /PHONE
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G
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CITY STATE ZIP CODE
AREA CODE /PHONE
NAME OF ASSISTANT TREASURER, IF ANY
�rt1.CLM`t C.A. q,00 -W
40 -S11I;2
MAILING ADDRESS (IF DIFFERENT)
STREET ADDRESS
CITY
STATE ZIP CODE
AREA CODE /PHONE
OPTIONAL: FAX/ E -MAIL ADDRESS
NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE
COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE
MAILING ADDRESS
CITY
STATE ZIP CODE
AREA CODE /PHONE
Attach additional information on appropriately labeled continuation sheets.
3. Verification
I have used all reasonable diligence in preparing this statement and to the best of my kngwledge 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 '7� �2 ai• ) By 7(
' Df TE ' SIGNATURE OF TREASURER OR ASSISTANT TREASURER
Executed on 2/� �/ � { By ��.a.�� V .
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
Executed on
DATE
DATE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)
Statement of Organization STATEMENT OF ORGANIZATION
Recipient Committee CALIFORNIA ,
FORM
INSTRUCTIONS ON REVERSE Page 2
COMfiqTTEE NAME �y - I.D. NUMBER
wive K
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.
OR
NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT AP HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
• List the financial institution where the campaign bank account is located (controlled "candidate election" committees only)
NAME OF FINANCIAL INSTITUTION
ADDRESS
AREA CODE /PHONE
CITY
BANK ACCOUNT NUMBER
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
)RT IOPPOSE
OPPOSE
FPPC Form 410 (January/05)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)