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CA Form 410 Jerry Duhovic for RPV City Council 2015Date Stamp Statement of Organization CALIFORNIA Recipient Committee p ' M 410 Statement Type ❑ Initial 0 Amendment ❑ Termination — See Part 5 For Official Not yet qualified ❑ or list I.D. number: List I.D. number: Cl OAMS OF RANCHO VERD S # 1340074 # AUG O 6 2015 08 01 It 2015 Date qualified as committee Date qualified as committee Date of Termination ITY CLERK'S OFFIcq (If applicable) 1,. Committee Information 2. Treasurer and Other Principal Officers NAME OF COMMITTEE NAME OF TREASURER JERRY DUHOVIC FOR RPV CITY COUNCIL 2015 ANGELA FELIX STREET ADDRESS (NO P.O. BOX) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE RANCHO PALOS VERDES CA 90275 ( SAN PEDRO CA 90731 ( MAILING ADDRESS (IF DIFFERENT) NAME OF ASSISTANT TREASURER, IF ANY PAUL FELIX FAX / E-MAIL ADDRESS STREET ADDRESS (NO P.O. BOX) ( COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE CITY STATE ZIP CODE AREA CODE/PHONE LOS ANGELES LOS ANGELES SAN PEDRO CA 90731 ( NAME OF PRINCIPAL OFFICER(S) JERRY DUHOVIC Attach additional information on appropriately labeled continuation sheets. STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE RANCHO PALOS VERDES CA 90275 ( 3. Verification I have used all reasonable diligence in preparing this statement and to the best of y k owledge the information contained herein is true and complete. I certify under penalty of perjury under the laws of the State of California th forego' g is tr a correct. 08/01/2015 Executed on By DATE I RE OF TR SURER OR ASSISTA T T EASURER 08/01/2015 Executed on By DATE OFC RO OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT 08/01/2015 Executed on By DATE TURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (Dec/2012) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER JERRY DUHOVIC FOR RPV CITY COUNCIL 2015 1340074 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION ADDRESS 4 . Type of Committee Complete the applicable sections. AREA CODE/PHONE ( CITY SAN PEDRO BANK ACCOUNT NUMBER STATE ZIP CODE CA 90732 • 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." • 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 CAN MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY JERRY DUHOVIC Rancho Palos Verdes City Councilmember 2015 ® Nonpartisan SUPPORT ❑ Nonpartisan .1y • - , 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, AS APPLICABLE) CHFCK nNF FPPC Form 410 (Dec/2012) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SUPPORT 1:1 OPPOSE El SUPPORT O 11 FPPC Form 410 (Dec/2012) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov