CA Form 410 Termination Ben Kelly for Rancho Palos Verdes City Council 2017 Statement of Organization Dalesr R ,
Recipient Committee R b ED
Statement Type InitialFor O
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0 Amendment 0 Termination—See Part 5 fry OF RAN (flc.al Use Only '
ID Not yet qualified FEB 2? 2018
or 7 10 2017 11 29 2017
•Date qualified as committee --J---r,/ ..__,/-a
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Date qualified as committee Date of termination �, �_-
1. Committee Information I.O. Number
(if applicable) 1397825 2. Treasurer and Other Principal Officers
NAME OF COMMITTEE NAME OF TREASURER
Ben Kelly for Rancho Palos Verdes City Council 2017 Benjamin Kelly
STREET ADDRESS(NO PO.BOX)
STREET ADDRESS NO PO.SOX) CITY STATE ZIP CODE AREA CODE/PHONE
Rancho Palos Verdes CA 90275 310
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY
Rancho Palos Verdes CA 90275 310
MAILING ADDRESS(IF DIFFERENT) STREET ADDRESS(NO PO.BOx)
E•MA.L ADDRESS(REQUIRED)/FAX(OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE
benjamin@littlebiackfish.com
COUNTY 0€DOMICILE PJRISDICTION WHERE COMMITTEE IS ACT.YE NAME OF PRINCIPAL OFFICER(S)
Los Angeles County
STREET ADDRESS(NO PO.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
3. verification
I have used ail reasonable diligence in preparing this statement and to
PROPONENT
Executed on BY
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFF.CEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
FPPC Form 410(October/2017)
FPPC Advice:advIcetttppc.ca.gov(866/275-3772)
vwvw.fppc.ca.gov