HomeMy Public PortalAboutForm 410 Amendmenty
D VCM o K -f-
Statement of Organization
r '�, f� - _ C;, ll�f, l r Dale
ft FILA
-
Recipient Committee
` CEIVED
irklie office of the Secretary of St -
�
Statement Type ® initial ❑ Amendment
/!; Terinloatl n – 8`'je Pa4(5 of the State of California
ForOffic(al Use Only
O Not yet qualified
or
€ , , , -
c,. °� � C1 1= r;{'ri - AUG 17 2020
0 Date qualification threshold met Date qualification threshold met Date of termination
08 06 2020 _�_/
__/_—✓
V �/
•glgI.D. Number
® e
_ o n-bie
NAME OF COMMITTEE
NAME OF TREASURER
Christine Margiotta for Claremont City Council 2020
Jordan Raphael
STREET ADDRESS (NO P.O. BOX)
,
611 Purdue Drive
STREETADDRESS (NO P.O. BOX)
CITY STATE
ZIP CODE AREA CODE/PHONE
624 Scripps Drive
Claremont _ CA
91711 (310)463-8452
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
Claremont CA 91711 (32-3) 712-8363
N/A
FULL MAILING ADDRESS (IF DIFFERENT)
STREET ADDRESS (NO P.O. BOX)
E-MAIL ADDRESS(REQUIRED)/FAX(OPTIONAL)
CITY STATE
ZIP CODE AREA CODE/PHONE
christineforclaremont@gmail.com
COUNTY OF DOMICILE
IURISOICTION WHERE COMMITTEE IS ACTIVE
NAME OF PRINCIPAL OFFICER(S)
Los Angeles
City of Claremont
Christine Margiotta
STREET ADDRESS (NO P.O. BOX)
62=1 Scripps Drive
Attach additional information on appropriately labeled continuation sheets.
CITY STATE
ZIP CODE AREA CODE/PHONE
Claremont CA
91.711 (323)712-8363
l nave usea an reasoname aingence In preparing inls statement ana to the Dest or my Knowleage the lntormat(on contained herein is true and complete. I certify under
penalty of perjury under the laws of the State of California that the regoing is true and correct.
Executed on 8/13/2020 By
DATE B RE O4Z:�111STANTIRIAILIRIR
Executed on 8/13/2020 By
DATE SIGNATUR F-CONTR yN G ON
EHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
DATE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CAN
ENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (August/2018)
FPPC Advice: advice6iPPc.ca.aov (866/275-3772)
www.fppc.ca.Rov
0
I
Statement of OrganizationCALIFORNIA
Claremont City Council District
2020
Nonpartisan
J
Recipient Committee
Qlstpolltkalparty below)
_
Nonpartisan
Partisan
(Ilstpolitical party be-ro–w–F—
INSTRUCTIONS ON REVERSE
-FO
Page 2
COMMITTEE NAME
I.D. NUMBER
Christine Margiotta 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/PHONEBANK
AC COUNT NUMBER
Wells Fargo
(909)398-1140
5302825905
ADDRESS
CITY
STATE ZIP 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, lisf 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 ... --
Christine Margiotta
—
ChristineMargiotta
Claremont City Council District
2020
Nonpartisan
J
Partisan
Qlstpolltkalparty below)
-
Nonpartisan
Partisan
(Ilstpolitical party be-ro–w–F—
Frimarily Formed Committee
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURES) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD ORMEASURE(S) JURISDICTION
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK nNF
V/A SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410(August/2018)
FPPC Advice: advice f pc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Page 3
COMMITTEE NAME
I.O. NUMBER
Christine Margiotta for Claremont City Council 2020
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 OFACTIVITY
N/A
List additional sponsors on an attachment.
NAME OF SPONSOR (INDUSTRY GROUP OR AFFILIATION OF SPONSOR
N/A
STREET ADDRESS NO. AND STREET
CITY
STATE ZIP CODE AREACODE/PHONE
Small ContriburorCommiffee
�;5zTermi'nafion_Re uirements By"signing the venficatton ;the treasurer .assistant;treasureravd or candidate; afficeho der; or onent`certi�thata`�1 of the foilowm wndi on's
..,, V , � �,:.�'�...�.havebeenm:�tThis 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@fppc.ca.gov (866/275-3772)
www.fonc.ca.gov