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Home My Public Portal About02. Form 410 Amendment, Statement of Organization Recipient Committee Statement Type Irl Initial Q Not yet qualified Amendment I❑ Termination —See Part or 0 Date qualification threshold met Date qualification threshold met 01 / 06 / 2020 I.D. Number 1 423232 (if applicable) NAME OF COMMITTEE Rachel Forester for Claremont City Council District One 2020 STREET ADDRESS (NO P.O. BOX) 660 W. Bonita Ave., Apt. 19F CITY STATE ZIP CODE AREA CODE/PHONE Claremont CA 91711 (951) FULL MAILING ADDRESS (IF DIFFERENT) P.O. Box 1061, Claremont, CA 91711 E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL) rachelforclaremont@gmail.com COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE Los Angeles Claremont, California Attach additional information on appropriately labeled continuation sheets. Date of termination NAME OF TREASURER Bonnie F. Emadi For Official Use Only STREET ADDRESS (NO P.O. BOX) 4205 Oak Hollow Rd. CITY STATE ZIP CODE AREA CODE/PHONE Claremont CA 91711 (909) 451-1904 NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE NAME OF PRINCIPAL OFFICER(S) Jeena Trexler-Sousa STREET ADDRESS (NO P.O. BOX) 444 7th Street CITY Claremont STATE ZIP CODE AREA CODE/PHONE CA 91711 (909) 870-8240 ...!2. �..;.:,.s;cr ,�.:. .., -.. -+ _ x.., '�"' ✓h...., -.... "'+` <: . r<:..,;''. � ,. ="€.'V'4.✓' -r ;,... 1.a. ?i,. J �. y ^e. .. z 'w.r b,'uy�"` � 'r"'°'- � tr y. ..es..,;;�,� s� y,K^;.a�� .,..s.�"�.- 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 1hat the foregoing is true and correct. - Executed on January 6, 2020 By DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER Executed on JG1 RlA lJLYV (o 12020 By -ATE p��SIGNATURIETROLLING HOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on 61 10A By DAT 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 Recipient Committee INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER Rachel Forester for Claremont City Council District One 2020 1 1423232 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER Bank of America (909) 451-0974 3251 3542 9972 ADDRESS cm STATE ZIP CODE 339 Yale Ave. Claremont CA 91711 • 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 CAN 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 MEASUREW JURISDICTION IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) rucrr nNr SUPPORT Nonpartisan Partisan (list political party below) Rachel Leigh Forester City Council 2020 0 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 MEASUREW JURISDICTION IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) rucrr nNr FPPC Form 410 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SUPPORT OPPOSE SURRT OPM 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 Page 3 COMMITTEE NAME - I.D. NUMBER Rachel Forester for Claremont City Council District One 2020 1423232 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 • List additional sponsors on an attachment. NAME OF SPONSOR STREET ADDRESS NO. AND STREET ❑ Date qualified CITY GROUP OR AFFILIATION OF SPONSOR STATE ZIP CODE AREA CODE/PHONE • 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 bythe 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. -- Leftover funds of ballot measure committees maybe 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