HomeMy WebLinkAbout2018.09.04_Heller_Jeff_Form 410_AmendmentStatement of Organization
Recipient Committee
Statement Type
❑ Initial
Q Not yet qualified
or
Q Date qualified as committee
1. Committee Information
NAME OF COMMITTEE
® Amendment ❑ Termination — See Part 5
08 r26 2018
Date qualified as committee Date of termination
I.D. Number
(if applicable)
ranIVED
City of Morro Bay
SEP 4 2018
City Clerk
CALIFORNIA 410
FORM
For Official Use Only
2. Treasurer and Other Principal Officers
NAME OF TREASURER
Friends of Heller for City Council-2018 Scott Lawson
STREET ADDRESS (NO P.O. BOX)
STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE
CITY
Morro Bay
STATE ZIP CODE AREA CODE/PHONE
CA 93442 805 MEE
MAILING ADDRESS (IF DIFFERENT)
P. O. Box 1526 Morro Bay, CA 93443
E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL)
COUNTY OF DOMICILE
San Luis Obispo
Morro Bay
CA 93442 805
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
CITY
STATE ZIP CODE AREA CODE/PHONE
JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S)
Morro Bay, CA Jeff Heller
Attach additional information on appropriately labeled continuation sheets.
STREET ADDRESS (NO P.O. BOX)
CITY
Morro Bay
STATE ZIP CODE AREA CODE/PHONE
CA 93442 805
3. Verification
I have used all reasonable diligence 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 Stat rect.
Executed on C� - /6) By
DA E RER OR ASSISTANT TREASURER
Executed on T .. if . i e By
DATE
Executed on By
DATE
Executed on By
DATE
ER, CANDIDATE, OR STATE MEASURE PROPONENT
ER, CANDIDATE, OR STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (February/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Jeff Heller for City Council 2018
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
Pacific Premier Bank
AREA CODE/PHONE BANK ACCOUNT NUMBER
805 995-4355
ADDRESS
898 Morro bay Blvd.
CITY
Morro Bay
STATE ZIP CODE
CA 93442
4. Type of Committee Complete the applicable sections.
Controlled Committee
• 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
(INCLUDE DISTRICT NUMBER IF APPLICABLE)
YEAR OF
ELECTION
CHECK ONE
PARTY
Jeff Heller
City Council
2018
Nonpartisan
Partisan
(list political party below)
/
n
Nonpartisan
Partisan
(list political party below)
n
❑
❑
Primarily Formed Committee
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE(S) 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
SUPPORT
OPPOSE
❑
❑
SUPPORT
OPPOSE
n
FPPC Form 410 (February/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov