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Home My WebLink About2012 Restore Saratoga 410Statement of Organization Recipient Committee Statement Type ❑ Initial Not yet qualified 0 or Date qualified as committee Type or print In ink Amendment I.D i utnber 300 6 1 22-1 -' ( ° Date qualified as committee (H.pplicab e) ❑ Termination - Sae Part 5 List ID number - Date of Termination RECEIVED AND FI WI the office of the S .• .1.`; 4 allforni AUG 08 2012 DEBRA BOWEN Secretary of Stat ENT OF ORGANIZATION C A I_ C)R NIA 1- O F2 M 410 1 Committee Information NAME OF COMMITTEE C_ a M OA r YTe-6 -To (2-65T>,S,4-12.4 T+lj f� STREET ADDRESS (NO PO BOX) � CITY (1) r� MAILING ADDRESS (IF DIFFERENT) STATE ZIP CODE 6.44 9v7v AREA CODE/PHONE :` oaae► -r-o(-A-1 A- 950 7 a COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE Attach additional information on appropnately labeled continuation sheets 2. Treasurer and Other Principal Officers NAME OF TREASURER -772AS Ii c t -c ( STREET ADDRESS (NO PO BOX) -R�� l� r4 7Sa�o CITY STATE PCODE AREACODE/PHONE NAME OF ASSISTANT TREASURER IF ANY (2 - STREET STREET ADDRESS (NO PO BOX) { �) CITY ‘;;2-ry C A , NAME OF PRINCIPAL OFFICER(S) STREET ADDRESS (NO P.0 BOX) rt ""172-eisr STATE ZIP CODE AREACODE/PHONE cA 9So7o CITY STATE i-l�- -ro �>R- C, - ZIP CODE AREACODE/PHONE 45-o? o '- 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 penury under the laws of the State of California that the foregoing is true and correct. %/ 17.-W (7,— By ("tot (( DATE / 31GNATURE OF t EAS ASSISTANT T DATE � Executed on Executed on Executed on Executed on DATE DATE By By By IGt 4, URE OF CONTR • LL NG OFFICEHOLDE' CANDIDATE, SATE E MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (June/09) FPPC Toll -Free Helpline 8615/ASK-FPPC (886/275-3772) Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME STATEMENT OF ORGANIZATION 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 "non-partisan " • If this committee acts jointly with another controlled committee, list the name and Identification number of the other controlled committee NAME OF CANDIDATE/OFFICEHOLDERSTATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECT ON PARTY 0 Non -Partisan ❑ Non -Partisan • List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE Primarily Formed Committee Primanly 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) JURISDICFION (INCLUDE DISTRICT NO. CITY OR COUNTY, AS APPLICABLE) CHECK ONE OPPOSE SUPPORT SUPPORT OPPOSE FPPC Form 410 (June/09) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE STATEMENT OF ORGANIZATION CALIFORNIA 410 FORM COMMITTEE NAME Go AAAAI TT -6E iLES T Page 3 1.0 NUMBER 1 3Z-9.3 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 p f Z= i The t o ; = SA:2.-4 "tom 6, A- ° s` P; . f� LA $ i ( O ) 4-t,-+- _ C 5 Rhin) LA of t --1-.24.-Dm 04 S . Sponsored Committee List additional sponsors on an attachment NAME OF SPONSOR NDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO AND STREET CITY STATE ZIP CODE Small Contributor Committee 0 Date qualified 5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that al 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 Govemment Code Section 89519 — Leftover funds of ballot measure committees may be used for political, legislative or govemmental purposes under Govemment Code Sections 89511 - 89518, and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5 FPPC Form 410 (June/09) FPPC Toll -Free Helpline 866/ASK-FPPC (8661275-3772)