HomeMy WebLinkAboutForm 410 - Tye, Steve - 2005.03.23 (Initial)Statement Type X Initial
Not yet qualified Ior
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Date qualified as committee
1. Committee Information
NAME OF COMMITTEE
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Type or print in ink
® Amendment
List I.D. number:
Date qualified as committee
(If applicable)
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i 3 GU ERY,
0 Termination — See Part',
List I.D. number: 'HA N p't t' 1
Date of Termination
2. Treasurer and Other Principal Officers
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
FAX / E-MAIL ADDRESS
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OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE
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Attach additional information on appropriatelylabeled continuation sheets.
STATEMENT OF ORGANIZATION
NAME64r-twq
TREASURER
T E
STREET ADDRESS
23850
STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE
MAILING ADDRESS
CITY STATE ZIPCODE AREA CODEIPHONE
3. Verification
I have used all reasonable diligence in preparing this statement and to the best of my knowledge t information contained erein 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 onBy
D h] —- E TREASURER ASST NT TREASURER
Executed on -3.1-7. By.,
Executed on DATE
Executed on
DATE
By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
By
SIGNATURE O CO O ING O F CE OI , CANDMIDNE, OR UTATE MEASURE PROPONENT
FPPC Form 410 (Jan/03)
FPPC Tall -Free Hemline: 866/ASK-FPPC
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•
INSTRUCTIONS ON REVERSE
Page 2
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4. Type of Committee Complete the applicable sections.
• 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 "non-partisan."
• 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
NAME OF CANDID/TE/OFFICEHOLDER/STATE MEASURE PROPONENT rlmr 1 I IIID IIICTPIr T NI IKARFR IF APPI WARI G\
YEAR OF ELECTION PARTY
• List the financial institution where the campaign bank account is located (controlled "candidate election" committees only)
NAME OF FINANCIAL INSTITUTION
AREA CODE/PHONE
BANK ACCOUNT NUMBER
VINEYAMP
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ADDRESS
CITY
STATE
ZIP CODE
. 9T1�1P3. , Xliri:ilr r R 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
(INCLUDE DISTRICT NO., CITY OR COUNTY, ASAPPLICABLE) CHECK ONE
FPPC Form 410 (Jan/03)
FPPC Toll -Free Helpline: 866/ASK-FPPC