HomeMy Public PortalAboutForm 410 Amendment (2)Statement of Organization
Recipient Committee
Statement Type ❑ Initial
Date Stamp
Amendment 10 Termination — see Part 5
O Not yet qualified
or
Q Date qualification threshold met Date qualification threshold met
0$ 1 26 , 2019
1. Committee InformationI I.D. Number 1419897
(if applicable)
NAME OF COMMITTEE
Yes! For Claremont — The Committee to Support Measure CR
STREET ADDRESS (NO P.O. BOX)
310 W. Radcliffe Drive
CITY STATE ZIP CODE AREA CODE/PHONE
Claremont CA 91711 626-720-7798
FULL MAILING ADDRESS (IF DIFFERENT)
2058 N Mills Ave, #425, Claremont, CA 91711
E-MAIL ADDRESS(REQUIRED)/FAX(OPTIONAL)
YesForClaremont@gmail.com
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
Los Angeles I Claremont, CA
Attach additional information on appropriately labeled continuation sheets.
Date of termination
2. Treasurer and Other Principal Officers
NAME OF TREASURER
Simon Brown
STREET ADDRESS (NO P.O. BOX)
2058 N Mills Ave, #333
For Official Use Only
CITY STATE ZIP CODE AKhALUUt/YnUNt
Claremont CA 91711 909-625-5350
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF PRINCIPAL OFFICER(S)
Laura Roach
STREET ADDRESS (NO P.O. BOX)
310 W. Radcliffe Drive
CITY STATE ZIP CODE AREA CODE/PHONE
Claremont CA 91711 626-720-7798
3. Verification
I have used all reasonable diligence in preparing this state nd to the be f my knowledge the information contained herein is true and complete. I certify under
penalty of perjury under the laws of the State of Ca mi tat the foregoin i and correct.
Executed on 10/25/2019 BY
DATE 5 GNATURE 1) TREASURER OR ASSISTANT TREAS
Executed onBY
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
Yes! For Claremont -- The Committee to Support Measure CR
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
CITY
BANK ACCOUNT NUMBER
STATE ZIP CODE
I.D. NUMBER
1419897
ADDRESS
4. Type of Committee Complete the applicable sections.
Controlled Committee i
• 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
Nonpartisan I Pa
Primarily Formed Committee 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)
Measure CR
Claremont, CA
Partisan
ist political party
party
CHECK ONE
SUPPORT OPPOSE
F71 n
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
1419897
vo.I Gnr riarernnnt — The Committee to Support Measure CR
4. Type of Committee (Continued)
PurposeGeneral 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
Sponsored Committee 1 List additional sponsors on an attachment.
NAME OF SPONSOR
GROUP OR AFFILIATION OF SPONSOR
—1.
STREET ADDRESS NO. AND STREET
I Small Contributor Committee
CITY
MAI C
Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that all at e TOIIOWIn9
• 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.
-- gislative or governmental purposes under Government Code Sections 89511- 89518, and are
Leftover funds of ballot measure committees may be used for political, le
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