HomeMy WebLinkAbout2021.09.20_Addis_Dawn_Form 410 AmendStatement of Organization
Date
Stamp
CALIFORNIA
Recipient Committee
410
Statement Type ❑ Initial ® Amendment ❑
Termination — see Part 5
City
ofd)W" Bsgniv
Q Not yet qualified
SEP
2 0 �021
or
O Date qualification threshold met Date qualification threshold met
Date of termination
F
06 3�2018
--/
City Clerk
Committee1. • • I.D. 0 M "I'l
2. Treasurer and Other Principal
Officers
IJappllca6le
NAMEOFCOMMITTEE
NAME OF TREASURER
Barbara Spagnola
Friends of Dawn Addis City Council 2022
STREET ADDRESS (NO P.O. BOX)
STREET ADDRESS (NO P.O. BOX)
CITY
STATE
ZIP CODE
AREA CODE/PHONE
Morro Bay
CA
93442
(
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
Morro Bay CA 93442 (
FULL MAILING ADDRESS (IF DIFFERENT)
STREETADDRESS (NO P.O, BOX)
E-MAIL ADDRESS (REQUIRED)/FAX (OPTIONAL)
CITY
STATE
ZIP CODE
AREA CODE/PHONE
daddis@morrobayca.gov
--m7JURISDICTION
COUNTY OF DOMICILE
WHERE COMMITTEE IS ACTIVE
NAME OF PRINCIPAL OFFICER(S)
San Luis Obispo
City of Morro Bay
Dawn Addis
STREET ADDRESS (NO P.O. BOX)
Attach additional information on appropriately labeled continuation sheets.
CITY STATE ZIP CODE
AREA CODE/PHONE
Morro Bay
CA
93442
(
3. Verification
I ave used a reasonab a ilisence n oreDarine t s statement an tote est o
my
now a ee the in ormatton contained
grain is trua
and rmminlato 1 rarti J unriar
penalty of perjury under the laws of the State of Ca ' rnia that the f oing is true and correct.
J250T Executed on /a , a2/ By
QDATE%
Executed on
Executed on
DATE
DATE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
sy
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Friends of Dawn Addis City Council 2022
All committees must list the financial Institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
Pacific Premier Bank
ADDRESS
898 Morro Bay Blvd
AREA CODE/PHONE
(805) 995-4355
CITY
Morro Bay
BANK ACCOUNT NUMBER
STATE
CA
ZIP CODE
93442
• 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.
I.D. NUMBER
1406734
• List the political party with which each officeholder or candidate is affiliated or check "nonpartisan." Stating "No party preference" is acceptable
• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
NAME OFCANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT
OR HELD
YEAR OF
PARTY
(INCLUDE DISTRICT NUMBER IF
APPLICABLE)
ELECTION
cHECK oNE
Dawn Addis
Council Member, City of Morro Bay
2022
Nonpartisan
Partisan
(list political party below)
Nonpartisan
Partisan
(list political party below)
Primarily formed to support or oppose specific candidates or measures in a single election. List below;
CANDIDATES) NAME OR MEASURES) FULL TITLE (INCLUDE BALLOT N0, OR LETTER)
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURES) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE}
CHECK ONE
SUPPORT
OPPOSE
=SUPPORTOPPOSE
FPPC Form 410 (August/2018)
FPPC Advice: adviceC�fp�c.ca.E!ov (866/275-3772)
www.fppc.ca.eov