HomeMy WebLinkAboutFitzpatrick Form 410 Terminate..
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Sta te,;1ent of Organizati on Date Stamp
Recipient Committee VED AND FILED
I of the Secretary of State Statement Typeo Initial D Amendment liZI Sta te of Cal ifo rn ia
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NAME Of COMMITTEE
John Fitzpatrick for Sar.1toga City Council 2020
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ST REET ADDRESS (NO P.O . BO X)
14435 C l3 ig Basin Wa) #164
CITY
Saratoga
FULL MAILING ADDRESSIIF DlfFERENl
E-MAIL ADDRESS (REQUIRED)/ FAX (Of IIO NAL)
johnfi tzf orsaratoga @grnail.com
STATE ZIP CODE
CA 95070
1434434
COU NTY Of DOMICILE
Santa Clara
JURI SDICTION WHERE COMMITTEE IS ACTIVE
City of Saratoga
AREA CODE/PHONE
669-256-0384
Attach addi tional i nform ution on appropr iately labeled continuation shee t s.
Date of term ina t ion
NAME O f TREASURER
John Fitzpatrick
STREET ADDRESS (NO P.O . BOX)
14435 C Big Basin Way #164
CITY
Saratoga
NAME Of ASSISTANT TREAS URER, If ANY
STREET ADDRESS (NO P.O. BOX)
CI TY
NA M E O f PRINCIPAL OFFICER(S)
STREET ADDRESS (NO P.O. BOX)
CITY
For Official Use On ly
STATE ZIP CODE AREA CODE/PHON E
CA 95070 669-256-0384
STAT E ZIP CODE AREA CODE/PHONE
STATE ZIP CODE AREA CODE/PHONE
ave used all reasonab li! diligence in preparing this st atement and to the best of my knowledge t he lnformation contai ned here in is true and comp let e.
pena lty of perju ry und er the laws of t he Sta t e of (ai)t~t the fo r ego ing is t rue and correct.
Executed on 1/29/2021
DA t
Executed o n 1/29/2021
DA t
Execu ted on
DA E
Exec uted on
DA E
By 7~6
-:=-= SIGNATURE OF TREASURER OR ASSISTANT TREASURER
SIGNATURE O F CONTROLLING OF FICEHOLDER, CANDIDATE, OR STATE MEASURE.PROPONENT B y ~~~~~~
By ~~------------------------~----~-----------~ SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
By -~-------,,,-.-------------------------------------~ SIGNATU RE OF CONTROLLING OFFICEH O LDER , CANDIDATE , OR STATE M EASURE PROPONENT
FPPC Fo rm 410 (August/2018)
FPPC Advice : _fillvi ce @fupc.ca.gov _(866/275-3772)
www.fp pc.c_a.go v
State1i1ent of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
John Fitzpatrick for Sarai< ga City Council 2020
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
Wells Fargo Bank
AREA CODE/PHONE
408-867-9671
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Pqe 2
1.D. NUMBER
1434434
BANK ACCOUNT NUMBER
6075233129
ADDRESS CITY STATE ZIP CODE
14428 BIG BASIN WAY :,ARAfOGA, CA, 95070
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List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled,
also list the elective offic,~ sought or held, and district number, if any, and the year of the election.
List the political party wi1 h which each officeholder or candidate is affiliated or check "nonpartisan." Stating "No party preference" is acceptable
If this committee acts joi11tly with another controlled committee, list the name and identification number of the other controlled committee.
NAME OF CANDIDATE/OFF CEHOLDER/STATE MEASURE PROPONENT
Jolm Fitzpatrick
ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE)
Saratoga City Council
VEAR OF
ELECTION
2020
PARTY
CHECK ONE
Nonpartisan
~
Partisan
Nonpartisan Partisan
~@#iJ&/c/m'rall Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME ORM :ASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER)
IF A RECALL, STATE "FlcCALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
(11st political party below)
Decline to State
(list political party below)
CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410 (August/2018)
FPPC Advice: advice(@f1;mc.ca.gov (866/275-3772)
www.fppc.ca.gov
3tatei,1ent of Organi1zation
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
E'.fldfffl1@S,i,t§fflj'flmll Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
D CITY Committee D COUNTY Committee D STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVI IY
E{iJ#·iMlfui•@«M list additional sponsors on an attachment.
NAME Of SPONSOR I INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREE1 ADDRESS NO. A' 1D STREET CIT'! STATE ZIP CODE AREA CODE/PHONE E-D--1--1--
~:{:Jf.fS/T "ftn1nattOIHB '" .• jt., e:'., -. '"--·
• This committee has o·ased to receive contributions and make expenditures;
• This committee does 'lot 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 a re 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(@tppc.ca.gov (866/275-3772)
www.fppc.ca.gov