HomeMy WebLinkAbout2021.01.04_Headding_John_Form 410 Amend�1 ,01.1 i-,441. V% A
Statement of Organization
'+ V
Date Stamp
,
• . ,
Recipient Committee
RECEIVED
• '
Statement Type ❑ Initial ® Amendment ❑
Termination — See Part 5
City of Morro Bay
For Official Use Only
Q Not yet qualified
or
O Date qualification threshold met Date qualification threshold met
Date of termination
City Clerk
Committee1. . I.D. Number 14116452.
Treasurer and Other'
(if o licable)
NAME OF COMMITTEE
NAME OF TREASURER
Headding for Mayor 2022
Homer Alexander
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)
STREET ADDRESS (NO P.O. BOX)
P.O. Box 2034 Morro Bay, CA 93443
E-MAILADDRESS(REQUIRED)/FAX (OPTIONAL)
CITY
STATE
ZIP CODE
AREACODE/PHONE
COUNTY OF DOMICILE
JURISDICTION WHERE COMMITTEE IS ACTIVE
NAME OF PRINCIPAL OFFICER(S)
San Luis Obispo
City of Morro Bay
John Headding
STREET ADDRESS (NO P.O. BOX)
Attach additional information on a
f appropriately labeled continuation sheets.
CITY
STATE
ZIP CODE
AREA CODE/PHONE
Morro Bay
CA
93442
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 State of Califor i I��th'at the fo
Executed on
ng is true and correct.
OF CONTROLLING OFFIC,fd16LDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (August/2018)
FPPC Advice: advice0a fppc.ca.gov (866/2753772)
W W W.TDPC,ca.goy
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Headding for Mayor 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
805A954355
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.
Page 2
I.D, NUMBER
• 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
John Headding
Mayor, 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) FULLTITLE (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
FPPC Form 410 (August/2018)
FPPC Advice: advice@fopc.ca.eov (866/275-3772)
www.TPPC,ca.gov