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Home My WebLink AboutPaul Kloecker - 2014 - Form 410 Amendment (June)Statement of Organization Recipient Committee Statement Type ❑ initial Not yet qualified ❑ or Date qualified as committee 1..Committee Information NAME OF COMMITTEE 124tr'I —y V- L0er-,I- t3P YAmendment List I.D. number: •7 / Z�, , it`s Date qualified as committee (if applicable) ❑ Termination — See Part 5 List I.D. number: Date of Termination Date Stamp JINN 214 'Cf'ERKKQ;:ncc CA 2. Treasurer and Other Principal Officers For Official Use Only 5TREET ADDRESS (NO P.O. BOX) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE CITY STATE ZIPCODE AREA CODE /PHONE 1 MAILING ADDRESS (IF DIFFERENT) NAME OF ASSISTANT TREASURER, IF ANY FAX / E-MAIL ADDRESS Q C V-:. 'L c.) t;.;(Z COUNTY OF DOMICILE r STREET ADDRESS (NO P.O. BOX) iL, ti'J M IURISDICTION WHERE COMM ITTEE ISACTIVE CITY STATE ZIP CODE AREA CODE /PHONE 1L �'� NAME OF PRINCIPAL OFFICERS) Attach additional information on appropriately labeled continuation sheets. 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 trr �I 7? By DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER Executed on (� X711 14' By `J • - . DA"F E SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on DATE Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT By SIGNATURE Of CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410(Dec /2012) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME pp 1I.D. NUMBER IP Or U l ►.-C? c:1Z 1; Orr f-c'- 1 �i. '1 �,fiZ � W tJ�c') (; \L C2 t 4, • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREACODE /PHONE BANK ACCOUNT NUMBER ADDRESS CITY °T•' ZIP conE 4 Type ofCommittee'� complete the a' ticable 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 eachr officeholder or candidate is affiliated or check "nonpartisan." • 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 CAN DI DATE/OFFICEHOLDER /STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY Q� (yam } c A L� Nonpartisan SULJT ❑ Nonpartisan • . • 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 MEASURES) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE FPPC Form 410;(Dec/2012) FPPC Advice: advice @fppc.ca.gov (866 /275 -3772) www.fppc.ca.gov SUPPORT OPPOSE SULJT OEl FPPC Form 410;(Dec/2012) FPPC Advice: advice @fppc.ca.gov (866 /275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee Statement Type ❑ Initial Not yet qualified ❑ or Date qualified as committee YAmendment List I.D. number: f # GA kZO(O •7 \0 Date qualified as committee (I( applicable) ❑ Termination — See Part 5 List I.D. number: Date of Termination 1. `Committee Information 2. NA 7 __... . _ - NAME OF COMMITTEE STREET ADDRESS (NO P.O. BOX) 00 ti �• CITY STATE ZIP CODE AREA CODE /PHONE MAILING ADDRESS (IF DIFFERENT) FAX / E-MAIL ADDRESS COUNTY OF DOMICILE r,SDICTION WHERE COMMITTEE IS ACTIVE Attach additional information on appropriately labeled continuation sheets. Date Stamp ECEIVED AND FILE the office of the Secretary of Sti of the State of California JUN 18 2014 For Official Use Only Treasurer, and . . _ Other Principal Officers NAME OF TREASURER. . -_.- - STREET ADDRESS (NO P.O. BOX) CITY SPATE ZIP CODE AREA CODE /PHONE NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE 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 knowledge the information contained herein is true and complete. I certify under penalty of perju ry under the flaws of the State of Cali�fo nia that the foregoing is true and correct. / Executed on (1 IA' By DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER Executed on � ' t S J 1 * By DAE SIGNATURE OF CONTROLLING OFFtCEHOLDE R, 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, CANDIDAIE, OR STATE MEASURE PROPONENT FPPC Form 410(Dec/2012) 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. NUMBER, • All committees must list the financial institution where the campaign bank account is located.' NAME OF FINANCIALINSTITUTION AREA'CODE /PHONE' ' -' " - ' BANK ACCOUNT NUMRCR ADDRESS CITY - ZIP COOS 7'-7-7 �r�s,r �� • C�'�La~t Ct� s0 2,0 4 Type of.Cornmitt ee 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." • 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 rim Primarily formed to support or oppose specific candidates ;or. measures in a single election. List below: CANDIDATE(5) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION CANDIDATE(S) NAME OR MEASURE(5) FULL TITLE'(INCLUDE BALLOT NO. OR LETTER) I .- • (INCLUDE DISTRICT NO.. CITY OR COUNTY. AS APPLICABLE) .. "... rucrr nuF - . 0c. t-& C i SUPPORT I i Nonpartisan I�IPPPP RR1t1 SULJT it ❑ Nonpartisan rim Primarily formed to support or oppose specific candidates ;or. measures in a single election. List below: CANDIDATE(5) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION CANDIDATE(S) NAME OR MEASURE(5) FULL TITLE'(INCLUDE BALLOT NO. OR LETTER) I .- • (INCLUDE DISTRICT NO.. CITY OR COUNTY. AS APPLICABLE) .. "... rucrr nuF - . " SUPPORT I i OPPOSE I�IPPPP RR1t1 SULJT it OPPOSE FPPC Form 410 (Dec /2012) FPPC Advice: advice @fppc.ca , govi(866 /275 -3772) www.fppc.ca.gov