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Home My Public Portal AboutForm 410 AmendmentStatement of Organization Date Stamp Recipient Committee Fr A Statement Type ❑ Initial ® Amendment ❑ Termination — See Part 5 OCT O Not yet qualified 2 3 2019 or C'T� Q Date qualification threshold met Date qualification threshold met Date of termination CLERK 10 14 2019 C'11y OF CLAREMOMT 1 Committee Information ' I.D. Numbed2 #Treasurer andlCther Qrmcipai Ofs�icers 1421389 z 4 (ifoppllcableJ ';..,, ,.'r. "... .x `' ,.•.;n:, _ �; ,.«*_.. o -_i - NAME OF COMMITTEE No on Measure CR STREET ADDRESS (NO P.O. BOX) 1495 Via Zurita Street CITY STATE I ZIP CODE AREACODE/PHONE Claremont CA 91711 310-849-0168 FULL MAILING ADDRESS (IF DIFFERENT) E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL) COUNTY OF DOMICILE IJURISDICTION WHERE COMMU IEt a ACl1v Attach additional information on appropriately labeled continuation sheets. For Official Use Only NAME OF TREA5URER Aundri§Johnson STREET ADDRESS (NO P.O. BOX) 1686 Sumner Ave CITY STATE ZIP CODE AREA CODE/PHONE Claremont CA 91711 310-849-0168 NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE NAME OF PRINCIPAL OFFICER(S) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/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 underthe laws of the State of California that the foreg-in is true and correct. )) Executed on I DI Zia o I I BY WE SIGN UREOFTREASURER 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 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization FINSTRUCTIONS Recipient Committee ON REVERSE Page 2 COMMITTEE NAME I.O. NUMBER No on Measure CR 1421389 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER US Bank 909-625-8655 1157520553791 ADDRESS CITY STATE ZIP CODE 393 W. Foothill Blvd. Claremont CA 91711 Y Tete thea Ilcable sections C ' 4T, a Ofott9ttttttee :Com h T f • 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 • 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) fHGfY nuc Measure CR Claremont SUPPORT Nonpartisan Partisan (list political party below) SUPPORT OppgSp El 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) fHGfY nuc Measure CR Claremont SUPPORT OPPDSE-. SUPPORT OppgSp 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 No on Measure CR 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 NUMMEM=List additional sponsors on an attachment. NAME OF SPONSOR STREET ADDRESS NO. AND STREET CITY INDUSTRY GROUP OR AFFILIATION OF SPONSOR Page 3 I.D. NUMBER 1421389 STATE ZIP CODE AREA CODE/PHONE ......... ,►r.►ra4.n►rn.r►rr.�crririir►rrr uc aye ❑ Date qualified 5 _ ermmatton Re wrements Bys+gnmg,the venficabon the,treasuret ass+stant treasurer"and/or candidate;.off;cehd der, or:pro orient cert Ghat aof ll ,the•followin nditions haVe.been,met:' ........_ _,... ... _...� ... ...... ..-... co... ., ,..., _ ..._...... _... • 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 AAst 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, legislatille 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@fppt.ca.gov (866/275-3772) www.fppc.ca.gov