CA Form 410 Termination Krista Johnson for RPV City Council 2017 Statement of Organization
RE( EVE
Recipient Committee CALIFORNIA
Statement Type C OF RANCHO PALOS FORM 41 0
❑Initial ❑ Amendment
® Termination—See Part 5 22018
For Official Use Only
Q Not yet qualifiedAPR
or 08/ 08 2017 03 27 2018
Date qualified as committee /_______/ .....-__._______._ .
Date qualified as committee Date of termination � �` O.v �K�,
,.
__,____t__,_..,t___
1. Committee Information I.D. Number . .
(if applicable) 1398133 1 2. Treasurer and Other Principal Officers
NAME OF COMMITTEE
NAME OF TREASURER
Krista Johnson for RPV City Council 2017
Pat Mckinsey
STREET ADDRESS(NO P.O.BOX)
STREET ADDRESS(NO P.O.BOX)
CITY
RollingHills
Estates CA 90274 310 406-9390
CITY STATE ZIP CODE
AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY
Rancho Palos Verdes CA 90275 310 508-3201
MAILING ADDRESS(IF DIFFERENT)
STREET ADDRESS(NO P.O.BOX)
E-MAIL ADDRESS(REQUIRED)/FAX(OPTIONAL)
CITY STATE ZIP CODE
kjohnsonRPV@gmal.com AREA CODE/PHONE
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
NAME OF PRINCIPAL OFFICER(S)
Los Angeles Rancho Palos Verdes, CA 90275
Krista Johnson
STREET ADDRESS(NO P.O.BOX)
Attach additional information on appropriately labeled continuation sheets. CITY STATE ZIP CODE AREA CODE/PHONE
Rancho Palos Verdes CA 90275 310 508-3201
3. Verification
I have used all reasonable diligence in preparing this statement and to the best of myknowledge the'
g information contained herein is true and complete. I certify under
penalty of perjury under th- laws of the State
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(February/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization
41 0
Recipient Committee
CALIFORNIA
INSTRUCTIONS ON REVERSE
FORM
COMMITTEE NAME
Page 2
Krista Johnson for RPV City Council 2017
I.D.NUMBER
1398133
• All committees must list the financial institution where the campaign
bank account is located.
NAME OF FINANCIAL INSTITUTION
Malaga Bank AREA CODE/PHONE BANK ACCOUNT NUMBER
310-732-1100
ADDRESS
CITY
STATE ZIP CODE
San Pedro CA
4. Type of Committee Complete the a pp a licabl sections90732
.
Controlled Committee
• List the name of each controlling officeholder,candidate,or
state measure proponent. If candidate or officeholder controlled, 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." Stating"No partypreference"P ence"is acceptable.
• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF PARTY
ELECTION
CHECK ONE
Nonpartisan Partisan (list political party below)
Krista Johnson
Rancho Palos Verdes City Council
2017 El Republican
Nonpartisan Partisan (list political party below)
Primarily Formed Committee Primarily formed to support oro oppose specific pecific candidates or measures in a single election. List below:
CANDIDATE(S)NAME OR MEASURE(S)FULL TITLE(INCLUDE BALLOT NO.OR LETTER)
IFA RECALL,STATE"RECALL"IN FRONT OF THE OFFICEHOLDER'S NAME. CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION
(INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE)C ION
CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410(February/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization
41 0
• Recipient Committee
CALIFORNIA
INSTRUCTIONS ON REVERSE
FORM
COMMITTEE NAME
Page 3
I.D.NUMBER
4. Type of Committee (Continued)
General Purpose Committee Not formed to support or
PP oppose specific candidates or measures in a single election.
Check only one box:
0 CITY Committee ❑ COUNTY Committee 0 STATE Committee 0 Political Party/Central
PROVIDE BRIEF DESCRIPTION OF ACTIVITY al Committee
Sponsored Committee List additional sponsors on an attachment.
NAME OF SPONSOR
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO.AND STREET
CITY
STATE ZIP CODE
AREA CODE/PHONE
Small Contributor Committee
Date qualified
S.Termination Requirements Bysigning the B g verification,the treasurer,assistant treasurer and/or candidate,officeholder,orr
p oponent certify that all of the following conditions have
expenditures; been met:
• This committee has ceased to receive contributions and make
• 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 q by the Political Reform Act disclosing all reportable transa
-- There are restrictions on the disposition of surplus campaign ct�ons.
Code Section 89519. P gn funds held by elected officers who are leaving office and by defeated candidates. Refer to Government
-- Leftover funds of ballot measure committees may be used for
Political, legislative or governmental purposes under Governm
C Regulation 18521.5. ent Code Sections 89511-89518,and are
subject to Elections Code Section 18680 and FPP
Clear Page Print
FPPC Form 410(February/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov