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HomeMy WebLinkAbout2021.04.15_Weiss_John_Form 410Statement of Organization Recipient Committee Statement Type ❑ Initial Not yet qualified ❑ or Amendment List I.D. number: q 1425263 ❑ Termination — See Part 5 List I.D. number: w Date qualified as committee Date qualified as committee Date of Termination (If applicable) 1. Committee Information NAME OF COMMITTEE for Mayor 2020 STREET CITY STATE ZIP CODE AREA CODE/PHONE Morro Bay CA 93442 MAILING ADDRESS (IF DIFFERENT) . Morro Bav, CA. 93442 FAX / E-MAIL ADDRESS COUNTY OF DOMICILE San Luis O ml ala �;lrwa�la\h7:17:7Y�6L �Ibli iii7FlaCMi 17q � of Morro Ba CA. Attach additional information on appropriately labeled continuation sheets. Date Stamp RECEIVED City of Morro Bay City Clerk 2. Treasurer and Other Principal Officers NAME OF TREASURER Dan R. Costley STREET ADDRESS (NO P.O. BOX) For Off vial Use Only CITY STATE ZIP CODE AREA CODE/PHONE Morro Bay CA 93442 NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE NAME OF PRINCIPAL OFFICERS) STREET ADDRESS (NO P.O. BOX) cirY STATE ZIP CODE AREA CODE/PHONE 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 th/e/7laws of the St ` ifornia that the oreg 'ng is rue nd co rE ct. Executed on O I / `��1 By Executed on z1 B DAT15y Executed on By DATE 21 Executed on DATE SIGNATIIAE OF CANDIDATE, OR STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (Dec/2012) FPPC Advice; advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov