HomeMy WebLinkAbout2016.09.29_Davis_Robert_Form 460Recipient Committee
Campaign Statement
Cover Page
Statement covers period Date of election if applicable:
from /
/i /1 (0 (Month, Day, Year)
SEE INSTRUCTIONS ON REVERSE through—C)/12,4 r 1 �c NO-4
1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. 2. Type of Statement:
O—Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure
0 State Candidate Election Committee Committee
Q Recall 0 Controlled
(Also c-plete Pad 5) O Sponsored
(MO complete Part 6)
❑ General Purpose Committee
• Sponsored ❑ Primarily Formed Candidate/
• Small Contributor Committee Officeholder Committee
• Political Party /Central Committee (AlwC-pfetePad I)
3. Committee Information
9
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SAD W'v i�> C r t ``") � Pik: Y � ;� (-- k
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE CODEIPHONE
CITY STATE ZIP CODE AREA CODE/PHONE
Date Stamp
RECEIVED
City of Morro Bay
Administration
COVER PAGE
Page 1 of _ I I
For Official Use Only
❑ Preelection Statement 0 Quarterly Statement
❑ Semi- annual Statement ❑ Special Odd -Year Report
❑ Termination Statement
,�. (Also file a Form 410 Termination)
1� Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
.
MAILING ADDRESS
CITY STATE ZIP CODE AREACODEIPHONE
NAME OFASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREACODE/PHONE
°
OPTIONAL: FAX/ E -MAIL ADDRESS
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete.
certify under penalty of perjury under the laws of the State of California that the foregoing is true
Executed on ':�)/z 0'�'/ I �0 By
Date or Assistant Treasurer
-�Ct �l�
Executed On Date Signature of Controlling Offlostiolcter, Canclidate, State Measure Proponent or Responsible Officer of Sponsor
Executed on
Date
Executed on Date
BY Signature of Controlling Officeholder, Candidate, State Measure Proponent
By
Signature of ControMng Officeholder, Candidate, State Measure Proponent
FPPC Form 460 (Jan /2016)
FPPC Advice: adviceWaDc.ca.¢ov (866/275 -3772)