HomeMy Public PortalAboutForm 410 InitialStatement of OrganizationafeSia
P CALIFORNIA
Recipient Committee
L
410
FORm
Statement Type ❑ Initial ❑ Amendment
❑ Termination — See Part 5
AUG 0 6 2020
For Official Use Only
m Not yet qualified
or
❑ Date qualification threshold met Date qualification threshold met
Date of termination
CITY CLERK
CIT G i.sLERK
C[
Y OF CLAREMON7
• D. Number
•
.. •
i a licable)
OF COMMITTEE
7Zach
NAME OF TREASURER
Courser for Claremont City Council 2020
Linda Moore
STREET ADDRESS (NO P.O. BOX)
413 Willamette Ln.
STREET ADDRESS (NO P.O. BOX)
CITY
STATE ZIP CODE
AREA CODE/PHONE
1142 N Cambridge Ave
Claremont
CA 91711
(909) 210-3704
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER; IF ANY
Claremont CA 91711 (617) 901-8787
FULL MAILING ADDRESS (IF DIFFERENT)
STREET ADDRESS (NO P.O. BOX)
E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL)
CITY -
STATE ZIP CODE
AREA CODE/PHONE
zcourser@gmail.com
COUNTY OF DOMICILE
JURISDICTION WHERE COMMITTEE IS ACTIVE
NAME OF PRINCIPAL OFFICER(S)
Los Angeles
City of Claremont
STREET ADDRESS (NO P.O. BOX)
Attach additional information on appropriately labeled continuation sheets.
CITY STATE ZIP CODE
AREA CODE/PHONE
i nave used all reasonable diiigence 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 Cal'fornia that the foregoing is true and correct.
Executed on By /
DATE A /1 f SIGNATURE OF TREASURER OR ASSISTANT TREASURER
('
Executed on -L � By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
DATE
Executed on
DATE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.eov (866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA
Recipient Committee FORM 0
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D. NUMBER
Zach Courser for Claremont City Council 2020
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
Wells Fargo (909) 398-1140 5302825889
ADDRESS CITY STATE 21P CODE
203 Yale Avenue 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 APPLICARLFI FI FrTInN
ZacharyCourser
Claremont City Councilperson, District 1
2020
Nonpartisan
Partisan
(list political party below)
Nonpartisan
Partisan
(list political party below)
Formed 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) rucrr nric
SUPPORT OPPOSE
SUPPORT OPPOSE
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
I.D. NUM
General • • 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
CITY
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
SIAIC — I—
Small Contributor Committee
^•••
❑ ---/ �—/
Date qualified
• 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.
— 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 lcpfppc.ca.goy (866/275-3772)
www.fppc.ca.gov