CA Form 410 Rancho Palos Verdes Good Leadership Committee, Sponsored by Long Point Development, LLC Statement of Organization Date Stamp
g CALIFORNIA 41 0
Recipient Committee FORM
Statement Type 0 Initial ❑ Amendment ❑ Termination—See Part 5 ' :Ae NCHO PALO v '1 t<br Official Use Only
0 Not yet qualified JUN 2 1 2O10
or
0 Date qualification threshold met Date qualification threshold met Date of termination
CLERK'S OFFIC
Committee n I.D. Number 2. Treasurer
1 C ttee I formation PENDING and Other Principal Officers
(if applicable)
NAME OF COMMITTEE NAME OF TREASURER
RANCHO PALOS VERDES GOOD LEADERSHIP COMMITTEE, SPONSORED BY LONG POINT
DEVELOPMENT, LLC CARY DAVIDSON
STREET ADDRESS(NO P.O.BOX)
515 S. FIGUEROA ST., STE. 1110
STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE
515 S. FIGUEROA ST., STE. 1110 LOS ANGELES CA 90071 (213)624-6200
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY
LOS ANGELES CA 90071 (213)624-6200 FLORA YIN
FULL MAILING ADDRESS(IF DIFFERENT) STREET ADDRESS(NO P.O.BOX)
515 S. FIGUEROA ST., STE. 1110
E-MAIL ADDRESS(REQUIRED)/FAX(OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE
(213)623-1692 / cary@politicallaw.com LOS ANGELES CA 90071 (213)624-6200
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S)
LOS ANGELES RANCHO PALOS VERDES TERRI A. HAACK
STREET ADDRESS(NO P.O.BOX)
28625 S. WESTERN AVE., STE. 147
CITY STATE ZIP CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
RANCHO PALOS VERDES CA 90275 (213)624-6200
I have used all reasonable diligence in preparing this statement and to the best of my ,i.wledge the information contained herein is true and complete. I certify under
penalty of perjury under the laws of the State of California that the foregoing is true d c• ect.
Executed on 6/20/2019 By
DATE SIGNA e F TR I' R OR ASSISTANT TREASURER
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
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
FPPC Form 410(August/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
netfile.00r77
Statement of Organization CALIFORNIA 41 0
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 2 of 3
COMMITTEE NAME I.D.NUMBER
RANCHO PALOS VERDES GOOD LEADERSHIP COMMITTEE, SPONSORED BY LONG POINT DEVELOPMENT, LLC PENDING
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
CALIFORNIA BANK & TRUST (213)228-1710 5796567476
ADDRESS CITY STATE ZIP CODE
550 S. HOPE ST., #100 LOS ANGELES CA 90071
firkindaommittee 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." Stating"No party preference" is acceptable.
• 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 YEAR OF PARTY
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION
CHECK ONE
Nonpartisan Partisan (list political party below)
Nonpartisan Partisan (list political party below)
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
IF A RECALL,STATE"RECALL"IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410(August/2018)
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 3 of 3
COMMITTEE NAME I.D.NUMBER
RANCHO PALOS VERDES GOOD LEADERSHIP COMMITTEE, SPONSORED BY LONG POINT DEVELOPMENT, LLC
PPT\TTlTN(
4.Type of Committee (Continued)
General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
TO SUPPORT LOCAL CANDIDATES
Sponsored Committee List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
LONG POINT DEVELOPMENT, LLC HOSPITALITY
STREET ADDRESS NO.AND STREET CITY STATE ZIP CODE AREA CODE/PHONE
28625 S. WESTERN AVE., STE. 147 RANCHO PALOS VERDES CA 90275 (213)624-6200
Small Contributor Committee ❑
/------/-------
Date
/Date qualified
q a y
5.Yerminat�orl Re uirements signing the verification,the treureistant treasurer and/or candidate,officeholder,or proponent certify that all of the following conditions have been met:
• This committee has ceased to receive contributions and make expenditures;
• 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 by the Political Reform Act disclosing all reportable transactions.
-- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government
Code Section 89519.
-- Leftover funds of ballot measure committees may be used for political,legislative or governmental purposes under Government Code Sections 89511-89518,and are
subject to Elections Code Section 18680 and FPPC Regulation 18521.5.
FPPC Form 410(August/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov