HomeMy WebLinkAbout2022.03.14_Costanzo_Form 410Staiamont of Organization
Recipient Committee
Statement Type Initial ❑ Amendment
❑ Termination —See Part 5
(('Not yet qualified
or
Q Date qualification threshold met Date qualification threshold met Date of termination
Date Stamp
ie office of the Secretary 01
of the State of Califamia
�9AR 14 2022
City
MAR 31 2022
• I.D. Number • ,
I a Ilcable
NAMEOFCOMMITTEE �('� 7NAMEOF TREASURER
�lrl�v\as Oq VkZO 4FOc- couvkC() 16124� ADDRESS (Nb P.O. B X)
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ADDRESS (NO P.O. BOX) CITY ATE 21P CODE AREA CODE/PHONE
CITY STATE ZIP CODE AREA OF ASSISTANT TREASURER, IF ANY
9
FULL MAILING ADDRESS FIF DIFFERENT) STREET ADDRESS (NO P.O. BOX)
E-MAIL ADDRESS (REQUIRED)/FAX (OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE
C:0S�ot-vt Zo � � � U� C I � 2 0 22, @ q ►��, t l , Co vK ���
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S)
v\LUt S Qbls o ec "Loa ro ae),t.OIMeS��gV1 ZO
STREET ADDRESS (NO P.O. BOX)
2d
additional information on appropriately CITY STATE ZIP CODE AREA CODE/PHONE
f ppropriate! labeled continuation sheets.
Verification3.
the
I have used all reasonable diligence in preparing this statement and to best of my knowledge the information contained herein is true and complete. I certify under
penalty of perjury under the laws of the State C fornia that the forego' g is true and 7corr
on /4 'X a By
ATE SIGNATUR EASURER OR ASSISTANT TREASURER
Executed on 9/10 By
DATE
SIGNATURE 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: advicegfppc.ca.eov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Fs-1)fVV*,65 CW C0'5 r .VNz o
\I 2cw>Z4�
• All committees must list the financial institution where the campaign bank account is located.
Page Z
I.D. NUMBER
DD
CITY STATE ZIP .D
4. Type of Committee Complete the applicable sections.
MIND
Controlled Committee
List the name of each controlling officeholder, candidate, or state measure proponent, If candidate or officeholder control ed,
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,
I ELECTIVE OFFICE SOUGHTOR
NAME OF CAN DIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT Dili
CHECK ONE
1
CANDIDATE(S)
YAea COS+0Vzo
��°� �c��Cc� mxp►rmbtr
Nonpartisan
Partisan (list political party below)
Nonpartisan
Partisan
(list political party below)
Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below:
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
11 nln � Inc nicro u^T ern
r�ry no rn.
ur.v e
._...._. .__ _... _.. .,...... ....... �...,...,.y IHtCK
SUPPORT
ONE
OPPOSE
SUPPORT
OPPOSE
FPPC Form 410 (August/2018)
FPPC Advice: adviceC�fppc.ca.�ov (866/275-3772)
www.fppc.ca.Roy
Statement of Organization CALIFORNIA
Recipient Committee 41
FORM
INSTRUCTIONS ON REVERSE
Page 3
4. Type of Committee (continued]
General Purpose CommitteeNot formed tosupport oppose specific candidates •nly one •
■CITY Committee■COUNTY Committee ■ STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
Sponsored Committee List additional sponsors on an attachment.
NAME OF SPONSOR
STREET ADDRESS
N0. AND STREET
Small Contributor Committee
Date nualifled -..
CITY
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
• This committee has ceased to receive contributions and make expenditures;
• This committee does not anticipate receiving contributions or making expenditures in the future;
STATE ZIP CODE
AREA CODE/PHONE
•
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.
— 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.
This committee has eliminated or has no intention or ability to discharge all debts, loans received, and
FPPC Form 410 (August/2018j
FPPC Advice: advice@fppc.ca.eov (866/275-3772)
www.fi)pc.ca.aov