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HomeMy WebLinkAbout410 - 09/08/2022_ Redacted (MD)Statement of Organization Date Stamp"For A Recipient Committee RECEIVEDStatement Type Initial ❑ Amendment ❑ Termination — See Part 5 ficial Use Only 0 Not yet qualified S E P S 2�22 or Date qualification threshold met Date qualification threshold met Date of termination p 3 / t S / i 0�-1 / CITY OF ARCADIA 1. Committee • I.D. Number2. Treasurer and Other Principal officers fl a licnble' VAME OFCOMMIT TFL NAME OF TRFASL?RFR Dar,idIS0n 40, r- Gi�y 0 AA1cNAEL {�2 CV, e�CC)L), !� C k C'L-c 1 Cz >q L S t) r 4 STREET ADDRESS (NO P.O. BOX) a*s- W gmvEy v C- S�3 STREET ADDRESS (NO P.O. BOX) " ._ 6 9 1 �v 5 s ) i V e w-ke CITYSTATE al V�� ey PAP� � CODE AREA CODE/PHONE c� 17 5'�6a&-a�o- aoa CITY STATE ZIP CODE AREA CODE/PHONE AY-,C,ciI 4C, D 6 f 0-4 `1363 NAME OF ASSISTANT TREASURER, IF ANY FULL MAILING ADDRESS (IF DIFFERENT) )L45 W.. G cArvey Ave * 5 13 STREET ADDRESS (NO P.O. BOX) E-MAIL ADDRESS (REQUIRED)/ FAX (OPTIONAL) a MC"(1 - L©vn CITY STATE ZIP CODE AREA CODE/PHONE Qan'te1sV,\-1L�Gi+'yc(7wACLi1 g COUNTY OF DOMICILE q JURISDICTION WHERE COMMITTEE ISACTIVE NAME OF PRINCIPAL OFFICER(S) `'f' C. C , U. 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 knowledge the intormaton contained herein is true and complete. I certity under penalty of perjury under the laws of the State of California that the foregoing is true and correct. / Executed on g ' t S .L Z By DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER b� / '3 i `-2-02.2- Executed on By O DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME 0a0'%(2lsiv` �o\1 DESCRIPTION OF ACTIVITY NAME OF SPONSOR CCUL'kV,C-� 1 2 & 2- Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee List additional sponsors on an attachment. STREETADDRESS NO. AND STREET CITY INDUSTRY GROUP OR AFFILIATION OF SPONSOR Page 3 I.D. NUMBER STATE ZIP CODE AREA CODE/PHONE Dace qva iitied TerminationS. • • 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 (August/2018) FPPC Advice: advice fppc.ca.gov (866/275-3772) www.fppC.ca.gov Statement of Organization CALIFORNIA Recipient Committee FORM 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 FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER wQ—coaa k Y® u%YeS X,0 ADDRESS CITY STATE ZIP CODE S�. I s+ Ave yet ci CA q! ®U 6 Controlled Committee V • 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. ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE G V� A D I' ry N t L C a, IV G C) Li /4 .C' i L- D; St Y. i C• to Z Nonpartisan iC Partisan (list political party below) Nonpartisan Partisan (list political party below) FormedPrimarily Committee yPrimarily 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 (August/2018) FPPC Advice: advice(@fnpc.ca.:Yov (866/275-3772) www.fPPC.ca.ROv