HomeMy WebLinkAbout2022.04.08_Addis_Dawn_Form 410 (termination)Statement of Organization
Recipient Committee
Statement Type 10 initial I0 Amendment
Not yet qualified
or
Date qualification threshold met I Date qualification threshold met
1. Committee Information I I.D. Number 1406734
(if applicable)
NAME OF COMMITTEE
Friends of Dawn Addis City Council 2022
STREET ADDRESS (NO P.O. 80X)
CITY STATE 21PCODE AREA CODE/PHONE
Morro Bay CA 93442 (
FULL MAILING ADDRESS (IF DIFFERENT)
EMAIL ADDRESS (REQUIRED) /FAX (OPTIONAL)
daddis@morrobayca.gov
COUNTY OF DOMICILE
San Luis Obispo
JURISDICTION WHERE COMMITTEE IS ACTIVE
City of Morro Bay
Termination — See Part 5
Date of termination
03 22 2022
/ /
REtVftD
City of Morro Bay
APR 4 8 2022
Administration
2. Treasurer and Other Principal Officers
NAME OF TREASURER
Barbara Spagnola
For Official Use Only
1
STREET ADDRESS (NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Palm Desert CA 92211 (
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF PRINCIPAL OFFICERS)
Dawn Addis
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets. Morro Bay CA 93442 (805) 234-4048
3. Verification
I have used all reasonable gence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under
penalty of perjury under the laws of the State of Calinia that the fore is true
rld correct.
Executed on By
DATE /
Executed on
DATLW
(By
l
OR ASSISTANT TREASURER
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 OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Clear Page Print
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
4. Type of Committee Complete the applicable sections.
AREA CODE/PHONE
(805) 995=4355
BANK ACCOUNT NUMBER
CITY STATE ZIP CODE
Morro Bay CA 93442
I.D. NUMBER
1403734
• 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:' 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 OF CANDIDATE/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
L! J
Partisan
❑
(list political party below)
Nonpartisan
El
Partisan
0
(list political party below)
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(SJ NAME OR MEASURE(5) FULL TITLE (INCLUDE BALLOT NO. OR LETTER)
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
Clear Page Print www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Friends of Dawn Addis City Council eme
4. Type of Committee (Continued)
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
NAME OF SPONSOR
S7REETADDRESS
Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee
List additional sponsors on an attachment.
N0. AND STREET
Date qualified
ci7v
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STATE ZIP CODE
Page 3
1406734
AREA CODE/PHONE
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;
• 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 (August/2018)
Clear Page Print FPPC Advice: advice@fppc.ca.gov (866/2753772)
www.fppc.ca.gov