HomeMy Public PortalAboutForm 410 Initialf �YYtO rx"IVt;trsu: t
meturned:
Statement of Or9 anization Date Stamp , • .
Recipient Committee •
Statement Type 0 Initial ❑ Amendment El Termination — See Part 5� R&Official Use Only
CEIVI':0
9 Not yet qualified DEC 17 2019 rn the. G`fice of the
or l/ of the Pceta►Y o `_zfate
Date qualification threshold met Date: qualification threshold met Date of termination I'
q q CITY
CLE G.(na
Y OF CLAREI IVE®A � -
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mI.D. Number ���n ago meStafa"o+Cslrfigr'jmaty ,*
aommlttee.lnforation
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reasurerandOthe,r Princl,palOfficers
"; (if applicable)
NAME OF COMMITTEE
Corey Calaycay for Claremont City Council 2020
STREET ADDRESS (NO P.O. BOX)
1555 W. Base Line Road
CITY STATE ZIP CODE AREA CODE/PHONE
Claremont CA 91711 %Q��593'S��� 3
FULL MAILING ADDRESS (IF DIFFERENT)
2058 N Mills Ave #722, Claremont, CA 91711
E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL)
spearson67@gmail.com
COUNTY OF DOMICILEJURISDICTION WHERE COMMITTEE IS ACTIVE
Los Angeles Claremont, CA
Attach additional information on appropriately labeled continuation sheets.
NAME OF TREASURER
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Susan Pearson
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STREET ADDRESS (NO P.O. BOX)
2461 San Jacinto Ct
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CITY
STATE ZIP CODE C--) ARE"I
DE/PH15.QTE�
Claremont
CA 91711
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NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF PRINCIPAL OFFICER(S)
Corey Calaycay
STREET ADDRESS (NO P.O. BOX)
1555 W. Base Line Road
CITY STATE ZIP CODE AREA CODE/PHONE
Claremont CA 91711
I have used all reasonable diligence in preparing this stat eme 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 Ca ' ni the foregoing is true and correct.
Executed on 12/17/2019 By
DATE SIGNATURE OFTREASUREROR ASSISTANT TREASURER
Executed on 12/17/2019 By E \
DATE
Executed on
Executed on
By
DATE
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 CALIFORNIA1
Recipient Committee • -
INSTRUCTIONS ON REVERSE
Page 2
CO MITTEE NAME � - I.D. NUMBER
c
• All committees must list the financial institution where the campaign bank account is ocated.
NAME OF FINANCIAL INSTITUTION I AREAAC�ODE/PHONE BANK ACCOUNT NUMBER
017e,u )-P-4 160,pyc gf�l7 . l ��Jf 2 3 5'0
ADDRESS CITY STATE ZIP CODE
• 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.
.t� 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 1„«,,, --
ej) 64 LOW -0
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ON %F
Nonpartisan
Partisan
0
(list political party below)
sua T
orPOSE
Nonpartisan
Partisan
El
(list political party below)
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
IFA RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY. AS APPLICABLE)
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
SUPPORT
❑
OPPOSE
❑
sua T
orPOSE
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov