CA Form 410 Eric Alegria for City Council 2017 RECEIVE
Statement of Organization cln�of RANCHO Att5 VENDED CALIFORNIA 410
Recipient Committee FORM
Statement Type �Initial 0 Amendment 0 Termination—See Part 5 AIM? 9 2017 For Official Use Only
Q Not yet qualified
or
0 Date qualified as committee Date lified as ommittee Da et of termination '�CLERK'S OFFICE
---/--/ (If amending to provide this date)
I.D.Number(,,____lcgble) ,,, c -0-.y '` ; v<
;1 Committee Information , ,. 2 Treasurer and Other Principal Officers
,
NAME OF COMMITTEE //�� / ^ / NAME OF TREASURER
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STREET ADDRESS(NO PO.BOX)
STREET D S P.O. ,` `' �� � CITY ( U , STATE ZIP CODE AREA CODE/PHONE
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�\ CITY STATE 'ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY -(/ -- .,
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MAILING
ADDRESS(IF DIFFERENT) STREET ADDRESS(NO P.O.BOX)
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E-MAIL ADDRESS(REQUIRED)/FAX(OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE
COUNTY OF DOXICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S)
IIL
STREET ADDRESS(NO P.O.BOX)
on appropriatelyCITY STATE 21P CODE AREA CODE/PHONE
Attach additional information
labeled continuation sheets.
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 nder t e laws of the State of Califo nia at the oregoing is true and correct.
Executed on / '2C� /1 By
D E
OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
Executed on By
DATE 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(May/2017)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA 41 0
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME
l + Al I.D.NUMBER
\C 4. LC 1- pC \ (A
• All committees must Tist the financial institution where the campaign bank account
is located.
NAME OFFINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
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ADDRESS CITY STATE
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•
Controlled Committee
• 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
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENTSOUGHTHE
OR(INCLUDE DISTRICT NUMBER IF D
APPLICABLE) YEAR OF ELECTION PARTY
Nonpartisan
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0 Nonpartisan
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) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION
(INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE
pI SUPPORT OPPOSE
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S C i C(JI �.ou►1ci 11�r(��Y`J'll
SUPPORT OPPOSE
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FPPC Form 410(May/2017)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov