CA Form 410 Matthew Vitalich for RPV City Council 2017 Statement of Organization ECEIV. _1.
CITY OF RANCHO PALOS VERDES CALIFORNIA 410
Recipient CommitteeFORM
Statement Type 0 Initial ® Amendment 0 Termination—See Part 5 OCT 16 2017 For Official Use Only
Q Not yet qualified
or 1016 17 .
•Date qualified as committee -/ / /--/-ti-( CLERKS OFFICE
Date qualified as committee Date of termination
10 /---/-___
0 / 16 17 (If amending to provide this date)
1. Committee Information I.D. Number(if applicable) 2. Treasurer and Other Principal Officers
NAME OF COMMITTEE NAME OF TREASURER
Matthew Vitalich For RPV City Council 2017 Lee Vitalich
STREET ADDRESS(NO P.O.BOX)
STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE
Rancho Palos Verdes CA 90275 310 824-3890
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY
Rancho Palos Verdes CA 90275 310 824-3890
MAILING ADDRESS(IF DIFFERENT) STREET ADDRESS(NO P.O.BOX)
Palos Verdes, CA 90275
E-MAIL ADDRESS(REQUIRED)/FAX(OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE
vitalichforrpv@gmail.com
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE - NAME OF PRINCIPAL OFFICER(S)
Los Angeles County Rancho Palos Verdes
STREET ADDRESS(NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
3. Verification
I have used all reasonable diligence in preparing
Executed on /0 l6 ` .2!3/7 By
DA EE )/` / / , '
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 410
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D.NUMBER
Matthew Vitalich For RPV City Council
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
Wells Fargo Bank N.A. 310 831-0632
ADDRESS CITY STATE ZIP CODE
28350 S Western Ave Rancho Palos Verdes CA 90275
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
Matthew Lee Vitalich Rancho Palos Verdes City Councilman 2017
0 Nonpartisan
I I I
Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION
CANDIDATE(S)NAME OR MEASURE(S)FULL TITLE(INCLUDE BALLOT NO.OR LETTER)
(INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410(May/2017)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov