HomeMy WebLinkAbout2022.01.28_Ford_Form 410Statement of Organization Date StampCALIFORNIA
, '
Recipient Committee -
Statement Type Initial ❑ Amendment ❑ Termination — See Part 5 RECEIVED For Official Use Only
® Not yet qualified City of Morro Bad
or 8
0 Date qualification threshold met Date qualification threshold met Date of termination JAN 220??
/ / / / / / Administration
I.D. Number
1. committee Information 2. Treasurer and Other principal Officers'
(if applicable)
NAME OF COMMITTEE NAME OF TREASURER
Jen Ford for Morro Bay City Council 2022
STREET ADDRESS (NO P.O. BOX)
5445
Madison
Avenue
CITY
STATE ZIP CODE AREA CODE/PHONE
Sacramento CA 95841 (916)348-9100
FULL MAILING ADDRESS (IF DIFFERENT)
E-MAIL ADDRESS (REQUIRED) /FAX (OPTIONAL)
campaigns@rcbs.us
/
(916)348-9111
COUNTY OF DOMICILE
JUR15U
Sacramento
WHERE COMMITTEE IS ACTIVE
City of Morro Bay
Attach additional information on appropriately labeled continuation sheets.
Denise Lewis
STREET ADDRESS (NO P.O. BOX)
5445 Madison Avenue
CITY
STATE ZIP CODE AREA CODE/PHONE
Sacramento CA 95841 (916)348-9100
NAME OF ASSISTANT TREASURER, IF ANY
Marissa Russell
STREET ADDRESS (NO P.O. BOX)
5445
Madison
Avenue
CITY
STATE ZIP CODE AREA CODE/PHONE
Sacramento
NAME OF PRINCIPAL
STREET ADDRESS (NO P.O. BOX)
an
I have used all reasonable. diligence in preparing this statement and to the best of my knowledge
penalty of perjury under the laws of the State of Califon
DATE
Executed on 1/18/2022 8y
DATE
Executed on By
DATE
OR STATE MEASURE PROPONENT
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.gov (866/275-3772)
www.fppc.ca.gov
netfde.com
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Jen Ford for Morro Bay City Council 2022
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
First Foundation Bank
AREA CODE/PHONE
(916)724-2424
BANK ACCOUNT NUMBER
i��a.Lr�,•aaaa
ADDRESS
CITY
STATE
ZIP CODE
2233
Douglas
Boulevard, Suite 300
Roseville
CA
95661
4. Type of Committee Complete the applicable sections.
' iiiiiiYii
• 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 OFCANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT
OR HELD
YEAR OF
PARTY
(INCLUDE DISTRICT NUMBER IF
APPLICABLE)
ELECTION
CHECK ONE
Jennifer N Ford
City Council Member City of Morro Bay
2022
Nonpartisan
X
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) FULL TITLE (INCLUDE BALLOT NO, OR LETTER)
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATE(5) OFFICE SOUGHT OR HELD OR MEASURE(S) IURiSDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc,ca.gov
Statement of Organization ° CALIFORNIA
Recipient Committee O _ 410
INSTRUCTIONS ON REVERSE
Page 3 of 3
COMMITTEE NAME
I.D. NUMBER
Jen Ford for Morro Bay City Council 2022
4. Type of Committee (Continued)
CommitteeGeneral Purpose Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee
PROVIDE BRf Ef DESCRIPTION Of ACTIVITY
NAME OF SPONSOR
List additional sponsors on an attachment.
rv�.nrvu �in¢i
Date qualified
CITY
GROUP OR AFFILIATION OF SPONSOR
S.'TeCmltlatiOn`itegUlrementS eysigningtfieverification,thetreasurer,assistanttreasurerand/orcandidate,officeholder,'
• This committee has ceased to receive contributions and make expenditures;
• This committee does not anticipate receiving contributions or making expenditures in the future;
STATE
• This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations;
• This committee has no surplus funds; and
• This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions.
ZIP CODE AREA CODE/PHONE
that all of the following conditions have been met:
-- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government
Code Section 89519.
-- Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511- 89518, and are
subject to Elections Code Section 18680 and FPPC Regulation 18521.5.
FPPC Form 410(August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www,fppc,ca.gov