HomeMy Public PortalAbout03. Form 410 Amendment (Treasurer 07-29-22)Statement of Organization
Recipient Committee
Stateme nt Type
NAM E OF COMM ITTEE
❑ Initial
® Not yet qualified
or
0 Date qualification threshold met
Date Stamp
Amendm ent 1 Termination — See Part 5
Date qualification threshold met
9 / 25 / 2021
D. Number 1439467
T �,ss6� aal rl
Jed Leano fo r Claremont City Council 2022
STREET ADDRESS (NO P.O. BOA]
CITY STATE 2W CODE ARE A CODE/PHONE
Date of t erminati on
reasurer an r Other Prindpal Officers
NAME OF TRE ASURER
Natalie Andres
STREET ADDRESS (NO P.O. E OM
4420 Los Feliz Blvd., #107
For Official Us e Only
1570 No rth Towne Ave.
Los Angeles
CA 90027 678-591-6548
CITY
Claremon t
STAT E
ZIP CODE
CA 91711
AREA CODE/PHONE
714-612-5871
N_ANN OF ASSISTA NT
SUR€R , IF AN T
FULL MAILIN G ADDRESS €IF D IFFERENT]
ST REE T A DORES StN O P_a eoX)
E-MAIL AD DRESS (REOHIR €D]/ FA X (O PTIONAL]
jedforclaremon t@gmail.com
CITY
STATE
AR €A CODEIPH.CA*
COUNTY OF DOMIME
Los Angeles
JURISDICTION WHERE COMM IT TEE !SA C/WE
C laremont, CA
NA ME OF PRINCIPAL OFFICER(S)
Attach a dditiona l informa tion on appropriately labele d continua tion shee ts.
have use d all reasonable diligence in preparing
penalty of perjury under the laws of the State of
Executed on 7/29/2022
DA TE
Executed on 7/29/2022 By
DATE
By
STREET ADDRESS ]N0 PO, BOO
nt and to the best of my knowledge the in orrnation containe. erein is true a :comp ete . I cart
ifornia that the forego4g is true and correct.
GE TFI€ASURER C:F ASSISTANT TREASURER
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANR OATS„ OR STATE MEASURE PROP ONEN T
Executed on By
DATE _-- SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE. OR STATE MEASURE PR OPONENT
Execu ted on By
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROP ONENT
FPPC Form 410 (August/2018)
FPPC Advice: advice(fppc.ca .rtov (866/275-3772)
www.fp oc.ca.gov
Statement of Organizati on
Recipient C ommittee
INSTRUCTI ONS ON REVERSE
LL NAME
Jed Leano for Claremont City Co uncil 2022
General Purpose Committee
Not formed to supp ort or opp ose specific candidates or measures in a single election. Check only one box:
0 CITY Committee ❑ COUNTY C ommittee ❑ STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
Re-election campaign for Jed Leano, Clarem ont City Council, District 4
List additional sponsors on an attachment .
NAME OF SPON SOR
I NDUSTRY GI OUP OR AFFILIATION OF SPON?
STREET ADD RESS
ET
CITY
STATE
LP CODE
AREA CODE/PH ONE
small Contributor Committee
0 _
Date quattEd
5 Terttllnatlon Requirements �Bysigningtheveriflcation,thetreasurer,assistantt and/or candidate,bfflceholder,orponentcertifythat albf the followingcondltlonshave beenmet •
• 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 obligati ons;
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 offic ers who are leaving office and by defeated candidates. Refer to
Govemment Code Section 89519.
- Leftover funds of ballot measure committees may be used for po litical, legislative or governmental purposes under G ov ernment C ode 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.fo pc .ca. eov
Stat ement of Organiz ati on
Recipient C ommittee
INSTRUCTIONS ON REVERSE
Pate z
1 COM MITTEE NAME
Je d Leano for Claremont City Council 2022
I,a NU NI
1439467
All committees must list the fina ncial Institution where the campaign bank account Is located.
NAME OF FINANCIAL INSTITUTION
Wells Fargo
AREA COOE/PHONE
9093981140
BANK ACCOUNT NUMBER
3302834670
ADORESS
Type of Committee Complete the applicable sections .
CITY
STATE
ZIP CODE
List the name of e ach controlling officeholder, candidate, or state measure prop onent. If candidate or officehold er controlled,
also list the e lective office sou ght or he ld, and district number, if any, and th e year of the election .
• List the political party with which each office holder or candidate is affiliated or check "nonpartisan." Stating "No party prefer ence" is acceptable
• If this co mmittee acts jointly with another controlled committee, list the name and identification number of the other contr olled committee.
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE)
YEAR OF
ELECTION
PARTY
CHECK ONE
Jed Leano
City Council, District 4
2022
Nonpartisan
✓
Partisan
(IIst political party below)
Nonpartisan
Partisan
(listpoRe cai party below)
Primarily Formed Comm ittee
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAM E OR M EASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER)
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAM E.
CANDIDATE(5) OFFICE S OUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
SUPP ORT
OPP OSE
SUPPORT
OPPOSE
FPPC Form 410 (August/2018)
FPPC Advice: advice @fpoc.ca.g ov (866/275-3772)
www.fppc .ca.gov