CA Form 410 Jerry Duhovic for RPV City Council 2015 •
Statement of Organization Date Stamp CALIFORNIA 410
Recipient Committee FORM
Statement Type 0 Initial 0 Amendment 0 Termination—See Part 5 For Official Use Only
Not yet qualified ❑ or List I.D.number: List I.D.number:
CITY OF RANCHO PALLS VERDES
4 1340074 AUG 06 2015
08 /01 /2015 / /
Date qualified as committee Date qualified as committee Date of Termination CITY CLERK'S OFFICE
(If applicable)
1. Committee Informatio rea incipal Officers
NAME OF COMMITTEE NAME OF TREASURER
• JERRY DUHOVIC FOR RPV CITY COUNCIL ELA FELIX
STREET ADD OX) STREET ADDRESS(NO P.O.BOX)
32415 NAUTILUS DR. 1151 ENGLANDER ST.
CITY STATE ZIP CODE A AT AREA CODE/PHONE
RANCHO PALOS VERDES CA 90275 (310)502-8036 SAN PEDRO CA 90731 (310)547-0889
MAILING ADDRESS(IF DIFFERENT) SISTANT TREASURER,IF ANY
PAUL FELIX
FAX/E-MAIL ADDRESS STREET ADDRESS(NO P.O.BOX)
(310)544-3032 jduhovichotmaiI.com ER ST.
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE STATE ZIP CODE AREA CODE/PHONE
LOS ANGELES LOS ANGELES SAN PEDRO CA 90731 (310)547-0889
NAME OF PRINCIPAL OFFICER(S)
JERRY DUHOVIC
STREET ADDRESS(NO P.O.BOX)
Attach additional information on appropriately labeled continuation sheets.
32415 NAUTILUS DR.
0 CITY STATE ZIP CODE AREA CODE/PHONE
RANCHO PALOS VERDES CA 90275 (3 502-8036
3. Verification
I have used all reasonable diligence in preparing this statement and to the best of owledge the information contained herein is true and complete. I certify under
penalty of perjury under the laws of the State of California th.
By
DATE SI .TURE OF CON ROLLING 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 CALIFORNIA 41 0
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D.NUMBER
JERRY DUHOVIC FOR RPV CITY COUNCIL 2015 13
• All nancial institution where the campaign bank account is located.
NAME OF STITUTION AREA CODE/PHONE BER
CHASE (310)521-9411 000000990514002
elADDRESS CITY STATE ZIP CODE
980 N. WESTERN AVE. SUITE A SAN PEDRO CA 90732
4 Type of Committee Complete the applicable sections.
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
JERRY DUHOVIC Rancho Palos Verdes City Councilmember 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
SU•••;T OP
■
FPPC Form 410(Dec/2012)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov