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HomeMy WebLinkAbout410 03/18/2016 Statement of Organization Initial - Gina Phillips30 statement of Organization Recipient Committee Statement Type ❑Initial Notyetqualifled 117 or I 3`WN-1 ❑ Amendment List I.D. number: Date qualified as committee Date qualified as committee (if appflcabla) Gina Phillips for City Council 2016 ❑ Termination — See Part 5 List I.D. number: fr — If / Date of Termination MAILING POOR ESS (IF DIFFERENT) FAX / EMAIL Orange Beach Attach additional information on appropriately labeled continuation sheets. penalty of perjury under the laws of the S Executed on / b - dw 6 By DATE Executed on - go By DATE NAME Dale Stamp R EIVE ®;Z in th office of the Secre4 of the State of Califc MAR 18 5 2o4,t 6 zCAf-'- MAR 2 5 2016 ( NAME OF ASSISTANT TREASURER, IF ANY Gina Phillips STREET ADDRESS INO P.O . BOX) NAME Of PRINCIPAL OFFICER(S) STREET ADDRESS (NO P.O. BOXI CITY STATE ZIP CODE AREA CODE /PHONE .paring this statement and to the best of my knowledge the information contained herein is true and corn Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR 57ATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 ()an/2016) FPPC Advice: advice @Dfppc.ca.gov (866/275 -3772) www.fppc.ca.gov 6 Statement of Organization Recipient Committee I NSTRUCTIONS ON REVERSE Gina Phillips for City Council 2016 • All committees must list the financial Institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER Farmers and Merchants Bank ( AuDrLss Cm STATE KIP CODE 4. Type of Committee Complete the applicable sections. ININI 1011101 1511 ONE NUMBER • 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 Gina Phillips City Council District 4 2016 Q Nonpartisan SUPPORT ❑ Nonpartisan E,� F Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) NAME ORMEASUREIS) FULL TITLE (INCLUDE BALLOT NO, OR LETTER) CANDIDATE(S) OFFICESOUGH70R HELDOR MEASUREIS )PURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE FPPC Form 410 ()an /2016) FPPC Advice: advice @fppc.ca.gm (866/275 -3772) www.fppc.ca.gov SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 410 ()an /2016) FPPC Advice: advice @fppc.ca.gm (866/275 -3772) www.fppc.ca.gov Statement of Organization ONE ,Recipient Committee INSTRUCTIONS ON REVERSE Poge3 for City Council 2016 4. Type of Committee (continued) 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 OESCR I PTI ON OF AMVITY �;' Sponsor�edCommrttee�ul . • . NAME OF SPONSOR ir..1 Date nuailNM 5. Termination Requirements By signing the verification, the treasurer, assistant treasurer 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; a 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: adviceWp ac.ca.gac (866/275.3772) vnvw.fppc.ca.gov