CA Form 410 Barbara Ferraro for Rancho Palos Verdes City Council 2019 4.
41
Statement of Organization REGEAaVERgCALIFORNIA 410
Recipient Committee CITY OF RANCHO PALOS VER FORM
Statement Type 14K initial 0 Amendment 0 Termination—See Part 5
JUL ...; 0 2019 For Official Use Only
0 Not yet qualified
or
ts.Date qualification threshold met Date qualification threshold met Date of termination
o SOC�
CITY
CLERK'S OFFICL
I.D. / / ._,,,..............._....,,_
Number
1. Committee Information 2. Treasurer and Other Principal Officers
(ifapplicable)(MJp :as:.y.?:- < .. ,,::�n.:: 5 3 s .r s c 2., f t <s -<.....,,,,.. < s .i:
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NAME OF COMMITTEE NAME OF TREASURER
.?arloara, cAa Pctios 1/ aharies V -Ferra.r-D
c7 coct ') r ` / 9STREET ADDRESS(NO P.O.BOX)
353o �
Seaq( hASTREET ADDRESS(NO P.O.BOX) , CITY STATE ZIP CODE AREA CODE/PHONE
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CITY STATE ZIP CODE AREA CODE/PHONE NAME F ASSISTANT TREASURER,IF ANY
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FULL MAILING ADDRESS(IF DIFFERENT) ) STREET ADDRESS(NO P.O.BOX)
E-MAIL ADDRESS(REQUIRED)/FAX(OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE
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COUNTY OF DONICILE JURISDICTION WHEREØcA
ITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S)
Av 5 A-Teies / oRlas J o Fe,rra_ro
STREET ADDRESS(NO P.O.BOX)
353o Sa3Iej (Dr.- 9*.a2y3--- S 10
CITY STATE ZIP CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
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3. verification
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 C • ornia that the foregoin: is true and correct.
Executed on 2.""19°D 1`�! A '
�r// By 11.'' PP".
DATE SIGN j RE OF TREASURER OR ASSISTANT TREASURER
Executed on 7.---a9 OW1 9 By % ' I Ilki
DATE /�� Kiri F CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE ASURE PROPONENT
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DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STAT EASURE 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
Statement of Organization CALIFORNIA
41 0
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME
I.D.NUMBER
2C2/1 C_40 reet—ck"._.c rout) / 9
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
Akda3a,-agf_n/ 3)6 -54/.-3000 673 /
ADDRESS /-4 CITY STATE ZIP CODE
g01-17 O /� 1/ks-�� eSPr (?0027174
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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
COWhC f 1 •--C 4;7 Of Nonpartisan Partisan (list political party below)
'Hal-ta Ferrcrôe)/?.
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 OP E
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
COMMITTEE NAME I.D.NUMBER
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4.Typsp,of Committee od}
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General Purpose Committee No 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
41)
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 ❑ j
Date qualified
5.Termination Requirements By signing the verification,the treasurer,assistant treasurer andjor candidate,officeholder,or proponent certify that all of the following conditions have been met:
- - .....STY a4;::. .:r�Y»ssr»�:vls,s6S>o»L.wss+»:e3Y?3d».&oil.',�i3rr3343diasxs�o$>�Sis>sJYDki'k�3:�ihsY:s.::. .?'a�tAA.tis?is'ivt•'s"w,x1o'i�k
• 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