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HomeMy WebLinkAbout410 08_09_2022 - Statement of Organization - Nathan Steele - InitialStatement of Organization Recipient Committee Statement Type I. Committee I NAME OF COMMITTEE Initial Not yet qualified [(or Date qualified as committee ❑ Amendment List I.D. number: Date qualified as committee )If applicable) ❑ Termination —See Part 5 List I.D. number: Date of Termination MAILING AD DR ESS I IF D IFFERENT) ZD• - 2. Treasurer al NAME OF TREASURER Date Stamp �5 (L it V WIN 1!1IE I FDr Official Use Only AUG 0 9 2022 CITY CLERK 'IT OF SEAL BEACH 1 Other Principal Officers 79AA/ _,E BOX) CITY — r — ,......,... __ Attach additional information on appropriately labeled continuation sheets. CITY STATE ZIP CODE AREA CODE/PHONE NAME OF PRINCIPAL OFFICERJS) STREET BOX) CITY STATE ZIP CODE AREA CODE/PHONE 3. Verification I have used all reasonable diligence correct. Executed on l 9.2,0 By DATE Executed onP DATE BY SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By GATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (Dec/2012) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE • All committees must list the financial institution where the campaign bank account is located. CITY 4. Type of Committee Complete the applicable sections. STATE ZIP CODE • 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 Primarily formed to support or oppose specific candidates or measures in a single election. List below: CAND I DATES) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT N0. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURES) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) PARTY Nonpartisan Nonpartisan CHECK FPPC Form 410 (Dec/2012) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE 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 DESCRIPTION OF ACTIVITY NAME MIA w STR EET ADD RESS I NO. List additional sponsors on an attachment. Date qualified GROUP OR AFFILIATION OF 5PONSOR ZIP CODE ------------•••--y— Dy mguirg me vermcanon, 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; • 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 (Dec/2012) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov