HomeMy Public PortalAboutForm 410 InitialStatement of Organization
Recipient Committee
Statement Type ® Initial ❑ Amendment
Q Not yet qualified
or
0 Date qualification threshold met Date qualification threshold met
08 06 . t 2020 — / I
1. D. Number
Termination — See Part 5 AUG 13 2020 For om� rales Use only
CITY CLERK
Date of termination C': TY OF CLAREMON r
) nave usea au reasonable diligence in preparing this statement and tote best ofmy� now a get the in ormatton containe erein Is true an comp ete. I certi y un er
penalty of perjury under the laws of the State of California that the regolhg is ijrue and correct.
Executed on 8/13/2020 By -
DATE --MOINATaE OF TREASUPEROR ASSISTANT TREASURER
Executed on 13/2020 B
GATE y '
SIG RE OF CONTR LUN DER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OFCONTROLUNG 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,(Rfp-aUq.,L(v (866/275-3772)
www.fpcca.gov
NAME OF TREASURER
- -- -
Christine Margiotta for Claremont City Council 2020
Jordan Raphael
STREET ADDRESS (NO P.O. BOX)
611 Purdue Drive
STREET ADDRESS (NO P.O. BOX)
CITY
STATE .
ZIP CODE
AREA CODE/PHONE
624 Scripps Drive
Claremont
CA
91711
(310)463-8452
CITY , STATE ZIP CODE AREACODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
Clardmont CA 9171.1. (323) 712-8363
N/A
FULL MAILING ADDRESS (IF DIFFERENT)
STREET ADDRESS (NO P.O. BOX)
EMAIL ADDRESS(REQUIRED)/FAX(OPTIONAL)
CITY
STATE
ZIP CODE
AREA CODE/PHONE
christineforclaremon t&gmail.com
COUNTY OF DOMICILE
JURISDICTION WHERE COMMITTEE IS ACTIVE
NAME OF PRINCIPAL OFFICER($)
Los Angeles
City of Claremont
Christine Margiotta
STREET ADDRESS (NO P.O. BOX)
624 Scripps Drive
Attach additional Information on appropriately labeled continuation sheets.
CITY
STATE
ZIPCODE
- AREA CODE/PHONE
Claremont
CA
91711
(3,23)712-8363
) nave usea au reasonable diligence in preparing this statement and tote best ofmy� now a get the in ormatton containe erein Is true an comp ete. I certi y un er
penalty of perjury under the laws of the State of California that the regolhg is ijrue and correct.
Executed on 8/13/2020 By -
DATE --MOINATaE OF TREASUPEROR ASSISTANT TREASURER
Executed on 13/2020 B
GATE y '
SIG RE OF CONTR LUN DER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OFCONTROLUNG 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,(Rfp-aUq.,L(v (866/275-3772)
www.fpcca.gov
Statement of Organization • -
Recipient Committee
NIA
INSTRUCTIONS ON REVERSE •-
M 410
Page 2
COMMITTEE NAME
Christine Margiotta for Claremont City Council 2020 I.D. NUMBER
• 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 5302825905
ADDRESS CITY STATE ZIPCODE
203 Yale Avenue x 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.
NAME OFCANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD YEAR -OF PARTY
11 Mfl I Inc INICTG1—...I—= l
I
• Primarily formed to support or oppose specific candidates or measures In a single election. List below:
CANDIDATES) 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 nF TNF npFlraunl MrCIC Menne
NIA
... ---------
�.........�.
CHECKONE
Christine Margiotta
Claremont City Council District 1
2020
Nonpartisan
Partisan
(Ilstpollticalpartybelow)
Nonpa san
Partisan(list
political party be w)
• Primarily formed to support or oppose specific candidates or measures In a single election. List below:
CANDIDATES) 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 nF TNF npFlraunl MrCIC Menne
NIA
����•- un wury i r, ha Rr rL16HtlLGI
CHECKONE
SUPPORT
OPPOSE
SUPPORT
OPPOSE
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.Pov (866/275.3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Christine Margiotta for Claremont City Council 2020
®lial Purposei t)7ittec Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Commitfee , ❑ STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
N/A
• �� List additional sponsors on an attachment.
NAMG OF SPONSOR
N/A
GROUP OR AFFILIATION OF SPONSOR
Page 3
�.ncc. nuunc�a NO. AND STREET - CITY STATE ZIP CODE AREA CODE/PHONE
T :.._
!fie ❑ ._�_�
• 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)
FPPCAdvice: advire(1Dfpng.ca.Rov (866/275.3772)
)9ww--fPPc.ca.eov