HomeMy WebLinkAboutForm 410 - Lin, Jimmy - 2018.08.08 (Initial)Statement of Organization
Recipient Committee
Statement Type il Initial ❑ Amendment
Not yet qualified Date qualified as committee
Date qualified as committee
1. Committee Information I.D. Number
(if applicable)
NAME OF COMMITTEE
ova 3 fted to lGt Mlm�
Date Stamp
❑ Termination —See Part 5 d a< z 1 for Official Use Only
t l AVG AN l
Date of termination
!1 ,S`r71.
2 "Treasurer and Other Principal Officers
NAME OF TREASURER
I yy&_-z�.
STREET ADDRESS IND P.O. BOX)
CITY STATE ZIP CODE AREACODE/PHONE
MAILING ADDRESS (IF DIFFERENT)
E-MAIL ADDRE55 {REQUIRED) f FAX (OPTIONAL)
.
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE 15 ACTIVE
Loi AN6aE_�> I D(ANAON,P -9A
Attach additional information on appropriately labeled continuation sheets.
STREET AODRESS INO P.O. BOX)
CITY STATE ZIP CODE AREA CODEIPHONE
p��f�
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O, BOX)
CITY STATE ZIP CODE AREACODF/PHONE
NAME OF PRINCIPAL OFFICER(S)
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Veri 'canon
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 foregoln is true and correct.
Executed on 191311.0 By
DATE SIG RE OF TREASURER OR ASSISTANT TREASURER
Executed on t t ?)By '
ATE slEiNATURI OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
DATE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (February/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization &OMNI
Recipient Committee '
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME ILO. NUMBER
All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
ADDRESS CITY STATE ZIP CODE
a, Type;of Colllmlttee Camq(ete the appl�ca6Ee 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.
a List the political party with which each officeholder or candidate is affiliated or check "nonpartisan." Stating "No party preference" is acceptable.
o 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 YEAR OF PARTY
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
�[ (V
aT� ��ft �i llf4J��l` Jvt� �
100(6
Nonpartisan
P;-'-'
Partisan
C�
(list political party below)
0
0
Nonpartisan
Partisan
(list political party below)
ly 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) CANDIDATE{S) OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION
rr A Drrnr r CTATr norrm o im [AnhIT nc TWr nrrim4n1 nFR'C NAMF. !INCLUDE DISTRICT NO.. CITY OR COUNTY, AS APPLICABLE)
CHF[K ONE
FPPC Form 410 (February/2018)
FPPC Advice; advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
SUPPORT
OPPOSE
0
0
SUPPORT
0
OPPOSE
FPPC Form 410 (February/2018)
FPPC Advice; advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Y Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME I.D. NUMBER
4. Type of Committee (Continued)
r Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY CommitteeEl STATE Committee ❑ Political Party/Central Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
p. r List additional sponsors on an attachment.
NAME OF SPONSOR €NOUSTRYGBOUP OR AFFILIATION OF SPONSOR
STREET ADDRESS N0, AND STREET CITY STATE ZIP CODE AREA CODE/PHONE
r r r ❑
Date qualified
S. TeCmination Requirements By slgning:the verification, the treasurer; assistant treasurer:and/or candidate 'officeWder, or proponent"certifythat�all of & following conditions have been met:
® This committee has ceased to receive contributions and make expenditures;
a 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 (February/2018)
Clear Pa e= Print
g FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov