410 Statement of Organization Recipient Committee – TerminationStatement of Organization Recipient Committee ~ CALIFORNIA 41 Q FORM Statement Type ,....1□-,n-iti-al ______ l~------~1-------:.y .... J_;',w~~l----ll D Amendment Ill termination -.I l"'\f"\l")t) For Official Use Only 0 Nol yet qualified or .) l'.'.U!'.'.l .0-iL. 0 Date qualification threshold met I Date qualification threshold met --1--1----1--1--Date of lem1inlition ~UPEffiTINO CITY CLERK NAME OF fHEASUR!.R Yuko5hTm'l fo, Cu.r-erJ-Tn (j C r+y Coun er/ 2-0.22 Hrr e1 tsu. 'f Tovvdt\.._ STREET ADDRESS (ND P.O. BOX) /o/ f/ &-q1 Is. C irc/-e vJ~t d STRH I ADllRtSS (NO P.O. BOX) {0 a,,k C rrc/-e. {IJ-e-..s+ J CITY C STATE ZIP CODE -erf{JI/ & crrv SrAII: NAME or ASSISTAN r I REASUIU:11, Ir ANY {!_ 'f.ftl 11 lJ CA FUI l MIIIUN\; ADOR[SS (IF DIFFrR[NT) STR[fT 1\DORrss (NO P.O. AOX) [·Ml\ll I\DDR(SS (REQUIRCDJ / FI\X (OPTION/IL) ·sh rm°'.. o 9@ h-0frr7 4.7/ -corn CITY STATE ZIP CODE CCIUNTV or DOMICILE avittA C./rA.rtf vi_ 'd-{-fl,r& NAMl Of PHI MCI PAL OHICEll(S) 7-/_ J ro f,:s u i:>du\_ STREET I\DDRCSS (NO P.O. BOX /0/9 s-We'5f \3 Attach additional information on appropriately labeled continuation sheets. Cll y C S IAI F LIi' CODE 1S-o /'f I have used all reasonable dill ~e,in preparing this statemenfand to the best of my knowfed~e th ,-formation confafn-ed herein is true and complete. penalty of perjury unde/4h aws of the State of California that the foregoing is true a co~r~-/ / I ~ Executed on Jbl-2.By I If °5.~ I :2,022-By --------~--.. "'-... -~--.-~-.. --... -~-c--.. -.. _--... _-·:·-··_-... -~-.... -.. --------DATE ·-.'!4 ..... ··-··--·--· ········---· ·-·--··-·-···-·----··-··-Executed on Executed on By _____ _ f1AIE SIGNATUR[ OF CONTROLLING OFFIC[IIOL[l[R, CIINDIDATr, on STATE Mfl\SUR[ PROPONENT Executed on DATE By------SIGNA\'UKL 01-CON I HOl I ING OHIUHOLDl:H, CANDIDA1 L, OHS IAI I Ml·ASUK[ PH.OPONl:N I AREA CODE/PHONE FPPC Form 410 {August/2018) FPPC Advice: advice@fppc.ca.gov {866/275·3772) www.f~ov
Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMl\llll ltl: NAMt l,(.,. tr J' hTma.. OUYl vi 202-z. CALIFORNIA 41 0 FORM . Page2 1.ll. NUMBER • All committees must list the financial institution where the campaign bank account is located. NAME OF F1NANC1/\L INSTITUTION All,A COD,/PHON, BANK ACCOUNT NUMBER l3~YJ/<. of A-~·-e.t',-C--°'-.___ (J.;. 0<t) 123-'l-2~ d2S -71/-Dtf -I 630 ADDRrss CITY STATE ZIP CODE 2. o S-£0 Controlled Committee • 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 Yuko S 11 JfYI c;\__ ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DIS I RIO NUMBER IF APPLICABLt) C~rtTviv e,,-ty CoLcM C-t-( I n1 ,e WJ b-e r YEAR OF ELcCIION )..o7.2 PARTY CH[CI< ONI· Nonpartisan V Nonpartisan Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) NAME OR MEASURC(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) IF A RECALL, STATF "RFCALL" IN FRONT OF THF 0FFICEH0LDF.R'S NAME. CANDIDATE(S) OFFICC SOUGHT OR HCLD OR M[ASURE(S) JURISDICTION (INCLUIJE DISTRICT NO., CITY OR COUNTY, AS APPLICARLE) P;irtis,:m Partisan (list politic.11 r1arty below) (list political party b~low) Cll~CK ONl SUPPORT OPPOS[ SUPPORT SUPPORT OPPOSE FPPC Form 410 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gol(
Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAMI:. " General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box: 0 CITY Committee O COUNTY Committee O STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY Sponsored Committee List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GHOUP OR AFFIUATION OF SPONSOR SIRttl ADDRESS NO. ANO SI REH CIIY SlAIE LIP CODE Small Contributor Committee □--1--1--Date _9uillificd CALIFORNIA 41 0 FORM ARtA coot/ PHONE :., .• s. Termination Requirements\ 'Ely signing the verification; tlie"tieasurer/assistant tr~asu~er'ancl/o/c~ndidate; officeholder, or ponent certifythat~II of.the following'condjtionshav~ b~en rnet'. -:\; • .'-., '_. • ··, , •.",•L ......... •·• -_,,: ,•.• ,-•.• ' ,·, .. • .. ,•.-'•••-•J•, •• ·,,:,!' ,·_.--.-1: -~.: .'. • ', ·, •-•·.•••-,,La';,·,.-·• '., ,;··. ---~'"-'.•,·• .. C.•":J · ._.,,•,-.,"-., •· •,•• .. ••·•·•. ·.-.:.· · ••_--••,.·•Jo·,••.-,.• .. -'-~.:• .. ,._-. .,_.·• •.•-~,t•~••-. .' . •.· '.' ._ ·-· ,",; .. ;'.•.:••, .. -• ~.' · '-· ·-" •-•~.-.. _, . .;:·•·• __ · • ... • ,.•.• ...... .-"., 'J·.•· •.--.•••.·,<"• .. ·~~••,•-. -_-·.-,.,, .. ,•,:;-• . ..[ .. · .·•:,--~•, ... ...._,.__;..;i....,,,:;,:,:.••0_ ·'••r'.'\ • This committee has ceased to receive contributions and make expenditures; 11/:i..v/20,2 • This committee does not anticipate receiving contributions or making expenditures in the future; }-ti rv+su j"' To yod fl\. • 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 I / / 2 D ( 2.0 2 2. Cf~~ • This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. YCAkD· 5hiJ'W'lO\ 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