HomeMy WebLinkAbout410 09/06/2016 Statement of Organization Recipient Committee - Schelly SustarsicStatement of Organization
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NAME OF COMMIiTF.E
Friends of Schelly Sustarsic for City Council 2016
STREET ADDRESS IND PO. BOX)
Orange
of Seal Beach
Attach additional information on appropriately labeled continuation sheets.
REC IVED
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`O VOTERS
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NAME OF TREASURER °
Patricia Campbell
STREET ADDRESS (NO PO. BOX)
STREET
CITY STATE ZIP CODE AREA CODE /PHONE
NAME OF PRINCIPAL OFFICEDS)
STREET ADDRESS (NO PO. BOX)
CITY STATE ZIP CODE AREA CODE /PHONE
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
penalty of perjury under the laws of the State
DATE U ATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
DATE
By
SIGNATURE OF CONTROLLING DFFICEHOL DER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (Jan /2016)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Statement of Organization
Rdcipient Committee
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IINSTRUCTIONS ON REVERSE
Friends of Schelly Sustarsic for City Council 2016
• All committees must list the financial institution where the campaign bank account is located.
INSTITUTION
Wells Fargo Bank
ADDRESS
CODE
Page 2
.D. NUMBER
4: -T a of Committee Complete the�appI lcable,sedtions % -, � - ,"'•i, . _ ,
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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 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."
If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
Schelly Sustarsic
City Council, District 4
2016
❑ Nonpartisan
SUPPORT
❑ Nonpartisan
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE($)FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANOIDATE(S) OFFICE SOUGHT OR HELD OR MEASURES ) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
FPPC Form 410 (Jan /2016)
FPPC Advice: advice @fppc.ca.gov )866/275 -3772)
www.fppc.ca.gov
SUPPORT
OPPOSE
SUPPORT
OPPOSE
FPPC Form 410 (Jan /2016)
FPPC Advice: advice @fppc.ca.gov )866/275 -3772)
www.fppc.ca.gov
St,Mement of Organization
F ecipient Committee
INSTRUCTIONS ON REVERSE
Vage 3
Friends of Schelly Sustarsic for City Council 2016
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 Or ACTIVITY
- List additional sponsors on an attachment.
NAME Or SPONSOR I INDUF RY G IOU P OR A r EDITION 0 1 1 PONSOR
STREET ADDRESS NO AND STREET CITY STATE ZIP CODE
El
Date qualified
5. Terminatlonittequlrement5, ',By Sign mg the verification; the `treasurer,assatanttreasurer 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 (Jan /2016(
FPPC Advice: advice @fppc.ca.gov (866/275 -3772(
www.fppc.ca.gov