HomeMy Public PortalAbout02. Form 410 Amendment (11-05-23)Statement of Organization
Recipient Committee
Statement Type 0 Initial
Q Not yet qualified
Or
Q Date qualification threshold met
® Amendment
Date qualification threshold met
11 / 04 / 2023
0 Termination — See Part 5
Date of termination
NOV 0 6 2023
CITY CLERK
CITY OF CLAREM
NT
CJ LIFORNIA 410
FORM
For Official Use Only
1. Committee Information
I.D. Number
(ii applicable)
2. Treasurer an.d Other Principal Officers
NAME OF COMMITTEE
Rachel Forester for Claremont City Council 2024
NAME OF TREASURER
Bonnie F. Emadi
STREET ADDRESS (NO P.O. BOX)
4205 Oak Hollow Rd.
CITY
Claremont
STATE ZIP CODE
CA 91711
STREET ADDRESS (NO P.O. BOX)
660 W. Bonita Ave., #19F
EMAIL ADDRESS OF TREASURER (REQUIRED)
bflinn@hotmail.com
AREA CODE/PHONE
909-451-1904
CITY
Claremont
STATE ZIP CODE AREA CODE/PHONE
CA 91711 951-533-2806
NAME OF ASSISTANT TREASURER, IF ANY
N/A
FULL MAILING ADDRESS (IF DIFFERENT)
STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE
E-MAIL ADDRESS OF COMMITTEE (REQUIRED) / FAX (OPTIONAL)
rachelleighforester@gmail.com
EMAIL ADDRESS OF ASSISTANT TREASURER (REQUIRED) AREA CODE/PHONE
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
Los Angeles Claremont
NAME OF PRINCIPAL OFFICER(S)
Anne Turner
Attach additional information on appropriately labeled continuation sheets.
STREET ADDRESS (NO P.O. BOX)
790 Santa Barbara Dr.
CITY
Claremont
STATE ZIP CODE
CA 91711
EMAIL ADDRESS OF PRINCIPAL OFFICER(S) (REQUIRED)
annekturner@msn.com
AREA CODE/PHONE
909-630-2535
3. Verification
I have used all reasonable diligence in preparing this 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
Executed on 1-0:3 By
DATE
Executed on Cc 16' a By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
DATE
SIGNATURE OF TREASURER OR ASSISTANT TREASURER
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
DATE
FPPC Form 410 (October/2023)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fpoc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
CALFIFORNIA 410
Page 2
COMMITTEE NAME
Rachel Forester for Claremont City Council 2024
I.D. NUMBER
• All committees must list the financial institution where the campaign bank account is located and the person(s) authorized to obtain bank records.
NAME OF FINANCIAL INSTITUTION AND PERSON(S) AUTHORIZED TO OBTAIN BANK RECORDS
Bank of America - Rachel Forester and Bonnie F. Emadi
AREA CODE/PHONE
909-451-8931
BANK ACCOUNT NUMBER
3251 8581 7547
ADDRESS OF FINANCIAL INSTITUTION
339 Yale Ave.
4. Type of Committee Complete the applicable sections.
Controlled Committee
CITY
Claremont
• 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, list the name and identification number of the other controlled committee.
STATE
CA
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE)
YEAR OF
ELECTION
PARTY
CHECK ONE
ZIP CODE
91711
Rachel Forester
City Council
2024
Nonpartisan
Partisan
(list political party below)
Nonpartisan
Partisan
(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)
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
SUPPORT
OPPOSE
SUPPORT
OPPOSE
FPPC Form 410 (October/2023)
FPPC Advice: advice@fopc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
I.D. NUMBER
COMMITTEE NAME
Rachel Forester for Claremont City Council 2024
ype of Committee (continued)
General Purpose Committee
Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee 0 COUNTY Committee 0 STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
Sponsored Committee
List additional sponsors on an attachment.
NAME OF SPONSOR
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO. AND STREET
CITY
STATE ZIP CODE AREA CODE/PHONE
Small Contributor Committee
E
0
Date qualified
/
ermination Requirements
By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or ponent certify that all of the following conditions have been met:
• 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 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 (October/2023)
FPPC Advice: advicena fppc.ca.eov (866/275-3772)
www.fppc.ca.gov