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CA Form 410 Susan Brooks for Rancho Palos Verdes City Council 2015 Statement of Organization Date sTED CALIFORNIA. . RECEIVED ' Recipient Committee FORM Statement Type • • CITY OF RANCHO PALOS VE 1 Yp ©initial ❑ Amendment ❑ Termination—See Part 5 For Official Use Only Not yet qualified 0 or List I.D.number: List I.D.number: AUG 0-7 2015 # # 07 14 2015/ / / / ICErY CLERK'S OCE Date qualified as committee Date qualified as committee Date of Termination (If app �:A. \ I �S a ..;':,,,,r7::, ,.::, ,. .. .. •, _r. .t.. '. .. .... V. c: .. >< a.. . .. >�. .,+' .fir y: .X. . �d �". f 4 �' k A" A i x .� t � l ,;'- -:.'"'''',.':'':,' 4. ♦ . Y. r ( N t++ r Y, I �1 i�, L I' NAME OF COMMITTEE NAME OF TREASURER Susan Brooks for Rancho Palos Verdes City Council 2015 Ann Marinovich STREET ADDRESS(NO P.O.BOX) STREET ADDRESS(NO P.O.BOX) 3419 Corinna Drive 7315 Berryhill Drive CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA.CODE/PHONE Rancho Palos Verdes CA 90275 (310)541-2971 Rancho Palos Verdes CA 90275 (310)377-8867 MAILING ADDRESS(IF DIFFERENT) NAME OF ASSISTANT TREASURER,IF ANY FAX/E-MAIL ADDRESS STREET ADDRESS(NO P.O.BOX) susan.brooks@rpvca.gov COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE CITY STATE ZIP CODE AREA CODE/PHONE • Los Angeles NAME OF PRINCIPAL OFFICER(S) ' STREET ADDRESS(NO P.O.BOX) Attach additional information on appropriately labeled continuation sheets. CITY STATE ZIP CODE AREA CODE/PHONE 0 3 / i . r -a. e� n r . 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 , ,` �,,,,:Y - DATE �4 SIGNATURE F TREASURER OR ASSISTANT TREASURER Executed on 06/14/2015 gy & ,. —, ,, -,,,,. DATE '� SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on By DALE 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 CALIFORNIA 41 0 Recipient Committee FORM INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D.NUMBER Susan Brooks for Rancho Palos Verdes City Council 2015 / -) • All committees must lis c e campaign bank account is locat NCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER Union Bank (310)519-7300 0041283318 ADDRESS CITY STATE ZIP CODE • 20 Miraleste Plaza Rancho Palos Verdes CA 90275 xo r f.. .' ... :-: .. .. ..a .:,. .. t .. ..: ....1", t... ..<, ... ... ..... � ,(.. *�. 1 I V .k .t . . ice � � . . 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 SOUGHT OR HELD NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY © Nonpartisan Susan Brooks Rancho Palos Verdes City Council 2015 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 SUPPORT OPPOSE El El SU•'•:T■ Oa,1FPPC Form 410(Dec/2012) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov