HomeMy WebLinkAbout410 - 06/21/2024 (DA)_ RedactedStatLftent of Organization
Recipient Committee
Statement Type Initial ❑ Amendment
Not yet qualified
or
Q Date qualification threshold met Date qualification threshold met
FORRIMI.D. Number
NAME OF COMMITTEE
'D AN \ D A?-N Z Q '� R
CvvN,c\\- 2n2-y
❑ Termination — See Part 5
STREET ADDRESS (NO P.O. BOX)
13Z1 H1G\ALA1\ 0 OAKS VR.
CITY STATE ZIP CODE AREA CODE/PHONE
ACZCAO I A Cps �,IO106 62 50
FULL MAILING ADDRESS (IF DIFFERENT)
E-MAIL ADDRESS OF COM ITTEE (REQUIRED)/ FAX (OPTIONAL)
Dovi Ar oauZoo6 gr'1oa� • �`"�
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
LOS AwcrF-LES I AZ C PVO 1 R
Attach additional information on appropriately labeled continuation sheets.
I have used all reasonable diligence in preparing this statement and to the best of my I
penalty of perjury under the laws of the State of California that o I t I
Executed on aVh e- ZO .2OAgBy
DATE AT R
Executed on 3�ne 201 Ao;Zgy
DATE #rGNATURE OF CONTROLLING OFF
Executed on
DATE
Executed on
DATE
By
Date of termination
Date Stamp
RECEIVED
J U N 2 1 2024
CITY OF ARCADIA
CITY CLERK
NAME OF TREASURER
-DAv\D ARv1Z�
For Official Use Only
STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE
13Z1 1-11 GNLA1-A0 pAKSI, ARCI 011^1 CA 9 ioo6
EMAIL ADDRESS OF TREASURER (REQUIRED) AREA CODE/PHONE
Uo v i A Arms i m6 g pio—k 1. com
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE
EMAIL ADDRESS OF ASSISTANT TREASURER (REQUIRED) AREA CODE/PHONE
NAME OF PRINCIPAL OFFICER(S)
-D Ay i D Ac v i 7—
STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE
%-32-1 �k�UHLA416 eAks; CA q 1006
EMAIL ADDRESS OF PRINCIPAL OFFICER(S) (REQUIRED) AREA CODE/PHONE
'D o v i d. IArzv iz u. v rl0-\' l b c ocn
ledge the information contained herein is true and complete. I certify under
rrect.
CANDIDATE, OR STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (October/2023)
FPPC Advice: advice a@fpnc.ca.aov (866/275-3772)
www.fooc.ca.¢ov
Statement of Organization • -
Recipient Committee FORM 411
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME `, /� ` ► ''] ;`�` 1 TY /� ( t I
-Dl� �[ � � AiZ V , L U F O `\ c \ \ \ CO V ' V C k t— 2-O �y I.D. NUMBER
• All committees must list the financial institution where the campaign bank account is located and the person(s) authorized to obtain bank records.
NAME OF FINANCIAL INSTITUTION AND PERSON(S) AUTHORIZED TO OBTAIN BANK RECORDS
ADDRESS OF FINANCIAL INSTITUTION CITY
AREA CODE/PHONE I BANK ACCOUNT NUMBER
STATE ZIP CODE
• 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" Stating "No party preference" is acceptable.
• 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 YEAR OF PARTY
(INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONF
��.v av AR �' Y Z 1,
c �T� cOUNck �tST
ZoZy
Nonpartisan
Partisan
(list political party below)
Nonpartisan
Partisan
(list political party below)
• 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
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410 (October/2023)
FPPC Advice: advice aCDfooc.ca.¢ov (866/275-3772)
www.foac.ca.izov
Statement of Organization iW:
Recipient Committee
INSTRUCTIONS ON REVERSE
7DN
COMMITTEE NAME
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
STREET ADDRESS NO. AND STREET
CITY
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STATE ZIP CODE AREA CODE/PHONE
Date qualified
5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or ponent 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 (October/2023)
FPPC Advice: advicePfoac.ca.eov (866/275-3772)
www.fuoc.ca.gov