HomeMy Public PortalAboutForm 410 Amendment0
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Poll FORM
410
initial Amendment Termination -,Qkw Part 5 CUD 2020
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Data of termination i CIT IV CLERK
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NAME OF COMMITTEE
NAME OF TREASVRER
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CITY STATE ZIP CODE
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3 NAME OF—ASSISTANT TREASURER, IF AN
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STREET ADDRES11 (NO POO. BOX)
STATE ZIP CODE
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NAME OF PRINCIPAL OFFICERIS)
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Executed on DATE ey SIGNATURE OF CDNTROWNG OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPORINf-
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DATE SIGNATURE OF 0DNTROLvNa OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FP PC Form 410 (August/2018)
FPPC Advice, DAY191022c.ca-90v (866/275-3772)
• Organization CALIFORNIA
- • _ .,FORD 410
INSTRLLCrIONS
COMMITtEENAMI
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NAME OF FINANCIAL INSTITUTION AREACOOUPHONE SANK ACCOURTNUMDEA
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List the name of each controlling officeholder, • . or state measure proponent. . ..
also list the elective office sought or held, and district number, If any, and the year of the election.
0 List the political party with which each officeholder or candidate Is affiliated or check "nonpardsam" Stating "No party preference Is acceptable
a 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
a a Nonp®rtisa. Partisan Old political party How)
Nonpa an Partisan I; jaMical party e
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) CANDIDATES) OFFICE SOUGHT OR HELD OR MEASURES) JURISDICTION
IF A RECALL, STATE'RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410 (August/2018)
FPPC Advice: g-vtCt€-vE. .rov (866/275-3772)
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