HomeMy WebLinkAboutFitzsimmons -Form 410 -Initial€ EC IVED owl
tATY MANAGER'S OFF1C"'
2020 MG 76 PM 12, 50
tF 5i'SATOOA
ARATOGA. Off,
Statement of Organization
CALIFORNIA
Recipient Committee
• -
Statement Type ® Initial ❑ Amendment
❑ Termination m See Part 5
For Official Use Only
Q Not yet qualified
or
O Date qualification threshold met Date qualification threshold met
Dale of termination
• • • 1.®. fVUrriber
• • Officers
(if applicable)
OFCOMMITTEE
NAME OF
7Rt.simmonsfor Saratoga Council 2020
Kathleen Fitzsimmons
STREET ADDRESS (NO PO. BOX)
STREET ADDRESS (NO P.O. BOX)
CITY STATE
ZIP CODE AREA CODE/PHONE
Saratoga CA
95070
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
Saratoga CA 95070
FULL MAILING ADDRESS (IF DIFFERENT)
STREET ADDRESS (NO P.O. BOX)
EMAIL ADDRESS (REQUIRED)/FAX (OPTIONAL)
CITY STATE
ZIP CODE AREA CODE/PHONE
electkoolde@gmail.com
COUNTY OF DOMICILE
IURISDICTIO"WIIERECONIMITTEEISACTIVE
NAME OF PRINCIPAL OFFICER(S)
Santa Clara
City of Saratoga
STREET ADDRESS IND P.O. SOX)
CITY STATE
ZIP CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
3. Verification
I ITAVP IKPri all rPAgnnAhlP dill9PnrP In nrenarin2 this Statement an athe best of my
knowledee the information contained herein is true and complete. I certify under
penalty of perlury u der the laws of the
Executed on e12 Ll B)
4 DATE
Executed on S 47" `% ' " B)
DATE
Executed on
DATE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE ME45URE PROPONENT
Executed On By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410(August/2018)
FPPC Advice: adviceLc7i fPpc.caovv (866/275-3772)
www.Fooc.Ca.aov
Statement of Organization
CALIFORNIA'
Recipient Committee
• -
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME
I.D. NUMBER
Fitzsimmons for Saratoga Council 2020
= All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
AREA CODE/PHONE
BANK ACCOUNT NUMBER
Bank of America
ADDRESS
CITY STATE ZIP CODE
Los Gatos CA 95030
4. Type of Committee Complete the applicable sections.
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 CAN MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
Nonpartisan
Partisan
(list political party below)
Koolde Fitzsimmons
City of Saratoga, Member, City Council
2020
*41
Nonpartisan
Partisan
(list political party below)
Kathleen Fitzsimmons
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATES) 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 0ifppD.ca.goy (866/275-3772)
N�4VWAP C.La.2OV
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Page 3
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 OFACTNITY
List additional sponsors on an attachment.
NAME OF SPONSOR
OFSPONSOR
Date qualified
Termination5.
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.aoy (866/275-3772)
wwW.fppc.ca.ROy