410 Statement of Organization Initial tatement of Organization
Recipient Committee ~Ype or print in ink
Statement Type Lyl Initial ^ Amendment
Not yet qualified ^ or List I.D. number:
4 #
Date qualified as committee Date qualified as committee
(If applicable)
1. Committee Information
STATEMENT OF ORGANIZATION
^ Termination -See Part
List I.D. number:
~~
Date of Termination
Date Stamp ~
p ~~C~Od~
r
AUG 2 5 2009
f'ERTINO CITY CLE K
2. Treasurer and Other Princi
For Official Use Only
NAME OF COMMITTEE
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STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREACODE/PHONE
NAME OF TREASURERC,~~, ~~ 11~~
STREETADDRESS (NO P.O. BOX)
f o ~.~' ~ ~ Dom- ,~~ ~~+~~ ~ ~
CITY STATE ZIP CODE AREA CODElPHONE
C~~T~n~ __ rte- 9~~ SL ~-6~~"~~~~
NAME OF
Cwt D~~ ~~~ u ' ~'' ~ ~~, ~ `~' ~",~~" ~~~~~~ STREETADDRESS (NO P.O. BOX)
MAILIN ADDRESS (IF DIFFERENT)
OPTIONAL: FAXlE-MAIL ADDRESS
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VIII JIA'1G Llt' VVUC ARCH VVUC/1'r1VIVC
~~'~. NAME OF PRINCIPAL OFFICER(S)
COUNTY WHE E COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE
Attach additional information on appropriately labeled continuation sheets.
STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
3.
Verification
have used all reasonable diligence in preparing this statement and to the best of
DAT
Executed on
DATE
Executed on
DATE
I certify under penalty of
gy
SIGNATURE OF CONTROLLING OFFICEHOLDER, CAND DATE, R STATE MEASURE PROPONENT
FPPC Form 410 (June/09)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
gy
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
~ ~ RY ~-Q ~~~g~ T~~ o
4. Type Of COmmlttee Complete the applicable sections.
STATEMENT OF ORGANIZATION
Page 2
• 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 CANDIDATElOFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION ~ PARTY
1-I'~~
~f'T~•c/c~ ~'~t C-c~u~elc.zL
YUD Non-Partisan
~
i
i ^ Non-Partisan
• List the financial institution where the campaign bank account is located (controlled "candidate election" committees only)
NAME OF FINANCIAL INSTITUTION I AREA CODElPHONE I BANK ACCOUNT NUMBER
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ADDRESS CITY STATE ZIP CODE
Gu~b RTZiJy ~ ~-~ I
- . 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 (June/09)
FPPC Toll-Free Helpllne: 866/ASK-FPPC (866/275-3772)