HomeMy Public PortalAboutCPOA PAC Form 425 (July 1 - December 31, 2021)Semi -Annual Statement of No Activity
Type or print In ink.
For use by recipient committees that have not received any contributions and have not made any expenditures
during the six-month period covered by a semi-annual statement. Candidate controlled committees formed for an
elective office may not use this form.
See the Information Manual on Campaign Disclosure Provisions of the Politiol Reform Act for additional information
and information required to be provided to you pursuant to the Information Practices Act of 1977.
1. Committee Information
OJ � Yi-- Pol;cQo
ADDRESS (NO 0,0, BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
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MAILING ADDRESS (IF DIFFERENT) NO. AND STREET
CITY STATE ZIP CODE AREACODE/PHONE
P 9 9 11
OPTIONAL: FAX/E-MAIL ADDRESS
2. Period of No Activity -
Treasurer(s)
NAME OF TREASURER
STATEMENT OF NO ACTIVITY
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601
CITY STATE ZIP CODE AKEA cwtirrnONt
NAME OF ASS
MAILING ADDRESS
ANY
-399-5Y
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX I E-MAIL ADDRESS
No contributions have been received and no expenditures have been made during the period covering the dates below: rr�� �
)6uly 1, through December 31, 20c�
Check one of the following boxes and complete the year.
❑ January 1, through June 30, 20
3. Verification
I have used all reasonable diligence in preparing this statement. I have reviewed the 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 California that the foregoing is true and correct.
Executed on , 1-' 222:
DATE
By
OF TREASURER/ASSISTANT TREASURER
FPPC Form 425 (Jan/01)
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866/275-3772