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Statement of Organization °atestamp CALIFORNI/ ',"
Recipient Committee 1FORMP 4 47
Statement Type ❑Initial mendment ❑ Termination—SeePart5 ForofficialUseonly
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in the office )f the Secretary of State
of the litate of California
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Date qualified as committee Date qualified as committee Date of Termination
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A EO^F�CtO/'yM�M I(T�JSTEEI �/'� f'01 �('-�,It^�/ �/-�\{^���/aNAME OFTREASURER �1C 3'1 no ' IJV R 1 cei 1 Ute ,_-. `-'lam
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N^G ADDRESS II DIFFERENT) NAME OF ASSISTANT TR L.,URER,IF ANY
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'LINTYORDOMICIL IURISDICTIDN ERE COMMITTEE IS ACTIVE CITY STATE ZIP CODE AREA CODE/PHONE
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NAME OF PgIN[IPAI OFFICERiSI
Attach additional information on appropriately labeled continuation sheets. srREETADDREss tno P.D.Box)
CITY STATE ZIP CODE AREA[ODE/PHONE
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 1� /Z.I // By
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DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER
Executed on By
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
By
DATE 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
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