y 5 STATEMENT OF ORGANIZATION
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1 r C Stateent f Organatn y 5 STATMT OF ORGAZATO Recpent Cttee fl Type r prnt n nk ate StaP CALFORA Stateent Type ntal Aendent Ternatn See Part 5 v Fr Offcal Use Only t yet qualfed r Lst.. nuber Lst.. nuber: FB# TUST _ J_ J J CTY,CLRK' S OFFC ate qualfed as cttee ate qualfed as cttee ate f Ternatn f applcable) 1. Cttee nfratn. Treasurer and Other Prncpal Offcers AM OF COMMTT AM' OF TRASURR STRT ARSS STRT ARSS( O P.O. BOX) CTY STAT ZP CO ARA CO/ PHO CTY STAT ZP CO ARA CO/ PHO AM OF ASSSTAT TRASURR, FAY MALG ARSS( F FFRT) STRT ARSS OPTOAL: FAX/ - MAL ARSS CTY STAT ZP CO ARA CO/ PHO AUST4TUST@GMAL. COM AM A POSTO OF OTHR PRCPAL OFFCR( S), F APPLCABL COUTY OF OMCL COUTY HR COMMTT S ACTV F FFRT THA COUTY OF OMCL MALG ARSS Attach addtnal nfratn n apprprately labeled cntnuatn sheets. CTY STAT ZP CO ARA CO/ PHO 3. Verfcatn 1 have used all reasnable dlgence n preparng ths stateent and t the best f ecuted n AT SGA' -' OF COTROG OFFCHOLR, CAAT, OR STAT MASUR PROPOT ecuted n ecuted n AT AT SGATUR OF COTROG OFFCHOLR, CAAT, OR STAT MASUR PROPOT SGATUR OF COTROG OFFCHOLR, CAAT, OR STAT MASUR PROPOT 4 FPPC Fr 41( January/5) FPPC Tll- Free Helplne: 866/ASK-FPPC( 866/75-377)
2 LJJ C:) r- 16 V.) t a( y= a C:) O T- M X X X L A 15 < LU, CL C : F - Z 4= ) cr f c c ad CQ L j v Uj Z) Z) ( n A LU U. A C > 1 > 1 > 1 > 1 M M M n ) P) cr L) r Cl) CL L) C= ca CZ Z L) C u t C: A? e ce ) c uj Of F- J crj < - - c 6 U 4?. C: C Q. 1) r ( F 34) n J T cr u 1 t - 6 a' J M cc b L < U tl T6 M 3: l 1 4 C) 4 Lj LJ cj L <: 3Uyv u- Z Lj C la C 13 _ ' 13 c > 1 L,. J 9-- = 5 = 5 = 5 t5 J a- M j a`) v CL 4Z 19 cn
3 Stateent f Organatn Recpent Cttee CV Pe ' tett 16 ': y TUST ate Stap RCV A FL. TASt1 STATMT OF ORGAZATO CALFORA Stateent Type ntal g A: ndrn p4 CLRK' S OFFCO T=rnatn See Part 9p the ffce f the Secretary f Stat: Fr Offcal Use Only Lst.... Lst.. nuber: f the State f Calfrna t yet qualfed l r l ate qualfed as cttee ate qualfed as cttee ate f Ternatn f applcable) f 16 JA Cttee nfratn. Treasurer and Other Prncpal Offcers L L 41 AM OF COMMTT LUMBAR FOR TUST CTY COUCL 16 AM OF TRASURR AUST J. LUMBAR STRT ARSS STRT ARSS( O P.O. BOX) CTY STAT ZP CO ARA CO/ PHO TUST CA 978 CTY STAT ZP CO ARA CO/ PHO AM OF ASSSTAT TRASURR, F AY TUST CA 978 MALG ARSS( F FFRT) STRT ARSS OPTOAL: FAX/ - MAL ARSS CTY STAT ZP CO ARA CO/ PHO COUTY OF OMCL ORAG COUTY HR COMMTT S ACTV F FFRT THA COUTY OF OMCL ORAG AM A POSTO OF OTHR PRCPAL OFFCR( S), F APPLCABL MALG ARSS Attach addtnal nfratn n apprprately labeled cntnuatn sheets. CTY STAT ZP CO ARA CO/ PHO 3. Verfcatn have used all reasnable dlgence n preparng ths stateent and t the best f y AT SGATUR - OTROG FFCHOLOR, CAAT, OR STAT MASUR PROPOT ecuted n AT SGATUR OF COTROG OFFCHOLR, CAAT, OR STAT MASUR PROPOT ecuted n AT SGATUR OF COTROG OFFCHOLR, CAAT, OR STAT MASUR PROPOT FPPC Fr 41 ( January/5) FPPC Tll- Free Helplne: 866/ASK- FPPC( 866/75-377)
4 Stateent f Organatn Recpent Cttee STRUCTOS O RVRS COMMTT AM STATMT OF ORGAZATO CALFORA Page.. UMBR 41 LUMBAR FOR TUST CTY COUCL Type f Cttee Cplete the applcable sectns. Cntrlled Cttee Lst the nae f each cntrllng ffcehlder, canddate, r state easure prpnent. f canddate r ffcehlder cntrlled, als lst the electve ffce sught r held, and dstrct nuber, f any, and the year f the electn. Lst the pltcal party th hch each ffcehlder r canddate s afflated r check" nn- partsan." f ths cttee acts jntly th anther cntrlled cttee, lst the nae and dentfcatn nuber f the ther cntrlled cttee. LCTV OFFC SOUGHT OR HL AM OF CAAT/ OFFCHOLR/ STAT MASUR PROPOT CLU STRCT UMBR F APPLCABL) YAR OF LCTO PARTY AUST J. LUMBAR TUST CTY COUCL 16 R n- Partsan n- Partsan Lst the fnancal nsttutn here the capagn bank accunt s lcated( cntrlled" canddate electn" cttees nly) AM OF FACAL STTUTO ARA CO/ PHO BAK ACCOUT UMBR S FARGO BAK,. A. 714) ARSS CTY STAT ZP CO 677 PARK AVU TUST CA 978 Prarly Fred Cttee Prarly fred t supprt r ppse specfc canddates r easures n a sngle electn. Lst bel CAAT( S) AM OR MASUR( S) FU TTL( CLU BAOT O. OR LTTR) CAAT(S) OFFC SOUGHT OR HL OR MASUR(S) JURSCTO CLU STRCT O., CTY OR COUTY, AS APPLCABL) CHCK O OPPOS OPPOS FPPC Fr 41 ( January/5) FPPC Tll- Free Helplne: 866/ ASK-FPPC( 866/ )
5 JA / Stateent f Organ. atn 1uCOPY Ty - r prnt n nk STATMT OF ORGAZATO TUST ate Stap Recpent Cttee CALFORA' r FOR ',,.. CTY CLRK' SOFFC41 L "'' rl ` ; '. : J., Lst. RCV. nuber: Lst. nuber: A J - `.( t yet qualfed r n the ffce Of the Se. - ' 1 r`- : t Stateent Type X ntal Aendent Ternatn See Parts t r sea "' "' C ate qualfed as cttee ate qualfed as cttee ate f Ternatn Fnal 1- Hf1 Ul" VOTRS applcable) VOpp' 1 y 1. Cttee nfratn j. Treasurer and Other Prncpal Offcers AM OF COMMTT LUMBAR FOR TUST CTY COUCL 16 AM OF TRASURR AUST J. LUMBAR STRT ARSS STRT ARSS( O P.O. BOX) CTY STAT ZP CO ARA CO/ PHO TUST CA 978 CTY STAT ZP CO ARA CO/ PHO AM OF ASSSTAT TRASURR. F AY TUST CA 978 MALG ARSS( F FFRT) STRT ARSS CTY STAT ZP CO ARA CO/ PHO OPTOAL: FAX/ - MAL ARSS COUTY OF OMCL ORAG COUTY HR COMMTT S ACTV F FFRT THA COUTY OF OMCL ORAG AM A POSTO OF OTHR PRCPAL OFFCR( S), F APPLCABL MALG ARSS Attach addtnal nfratn n apprprately labeled cntnuatn sheets. CTY STAT ZP CO ARA CO/ PHO 3. Verfcatn have used all reasnable dlgence n preparng ths stateent and t the best f y knledge the nfratn cntaned heren s true and cplete. certfy under penalty f perjury under the las f the State f Calfrna that the fregng s true and crrect. ecuted n CMBR 3, 15 AT SGATUR OF ' F TROG OF CHOLR, CAAT, OR STAT MASUR PROPOT ecuted n AT SGATUR OF COTROG OFFCHOLR CAAT. OR STAT MASUR PROPOT ecuted n AT SGATUR OF COTROG OFFCHOLR CAAT, OR STAT MASUR PROPOT FPPC Fr 41( January/ 5) FPPC Tll- Free Helplne: 866/ ASK- FPPC( 866/ )
6 Stateent f Organatn Recpent Cttee STRUCTOS O RVRS COMMTT AM STATMT OF ORGAZATO CALFORA Page.. UMBR 41 LUMBAR FOR TUST CTY COUCL Type f Cttee Cplete the applcable sectns. Cntrlled Cttee Lst the nae f each cntrllng ffcehlder, canddate, r state easure prpnent. f canddate r ffcehlder cntrlled, als lst the electve ffce sught r held, and dstrct nuber, f any, and the year f the electn. Lst the pltcal party th hch each ffcehlder r canddate s afflated r check" nn- partsan." f ths cttee acts jntly th anther cntrlled cttee, lst the nae and dentfcatn nuber f the ther cntrlled cttee. LCTV OFFC SOUGHT A RR HL HL AM OF CAAT/ OFFCHOLR/STAT MASUR PROPOT CLU STRCT UMBR F APPLCABL) YAR OF LCTO AUST J. LUMBAR TUST CTY COUCL 16 PARTY n- Partsan fl n- Partsan Lst the fnancal nsttutn here the capagn bank accunt s lcated( cntrlled" canddate electn" cttees nly) AM OF FACAL STTUTO ARA CO/ PHO BAK ACCOUT UMBR ARSS CTY STAT ZP CO Prarly Fred Cttee Prarly fred t supprt r ppse specfc canddates r easures n a sngle electn. Lst bel CAAT(S) AM OR MASUR( S) FU TTL( CLU BAOT O. OR LTTR) CAAT( S) OFFC SOUGHT OR HL ORMASUR( S) JURSCTO CLU STRCT O., CTY OR COUTY,AS APPLCABL) CHCK O OPPOS OPPOS FPPC Fr 41 ( January/ 5) FPPC Tll- Free Helplne: 866/ASK- FPPC( 866/ )
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