HomeMy WebLinkAbout2021.02.02_Addis_Dawn_Form 410 AmendStatement of Organization
Date Stamp
CALIFORNIA
Recipient Committee
•
, '
-
RECEIVED
Statement Type ❑ Initial ®Amendment ❑Termination
-See Part 5
City of Morro Bay
For O
Official Use Only
Q Not yet qualified
or
i EB 2021
Q Date qualification threshold met Date qualification threshold met
Date of termination
06 / 30 / 18
/ /
City Clerk
1. Committee Information I.D. Number 1406734
9(ij
•
Officers
applicable)
NAME OF COMMITTEE
NAME OF TREASURER
Friends of Dawn Addis City Council 2022
Barbara Spagnola
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)
E-MAIL ADDRESS (REQUIRED)/ FAX (OPTIONAL)
CITY
STATE
ZIP CODE
AREA CODE/PHONE
daddis@morrobayca.gov
COUNTY OF DOMICILE
JURISDICTION 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
1-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 Calif 'a that the f ng is tru nd correct.
Executed on /y . > 0 g2c2/ By
DATE '% IGN
SIGNA OF%Gdr?fR61_TL1NA OFFICEHOLDER, 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: advice@fppc.ca.¢ov (866/275-3772)
WWW.fopcWW caRoov
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.
Page 2
I.D. NUMBER
1406734
"
• 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
l
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 MEASURE(S) FULL TITLE (INCLUDE BALLOT N0, OR LETTER)
IF A RECALL, STATE RECALLIN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATES) OFFICE SOUGHT OR HELD OR MEASURES) JURISDICTIO
CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.Qov (866/2753772)
www.fppc.ca.eov