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HomeMy WebLinkAbout2023.01.25_Headding_Form 410 AmendStatement of Organization Date Stamp . Committee RECEIVED ,Recipient -Statement Type ElInitial ® Amendment Termination -See Part 5 City of Morro Bay❑ Fr-r officialUseOnly Q Not yet qualified JAN 2 5 2023 or Q Date qualification threshold met Date qualification threshold met Date of termination / / City Clerk —, , I Committee1. • • I.D. Number 14116452. Treasurer and Other PrincipalOfficers (i(a licable) NAME OF COMMITTEE NAME OF TREASURER Headding for Mayor 2024 Homer Alexander STREET ADDRESS (NO P.O. BOX) STREETADDRESS (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 93442 E-MAIL ADDRESS (REQUIRED)/FAX (OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE johnheaddingformayor@gmail.com 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 appropriately labeled continuation sheets. CITY STATE ZIP CODE AREA CODE/PHONE 3. Verification Morro Bay CA 93442 I have used all reasonable diligence in preparing this st penalty of perjury under the laws of the State of Califo Executed on % G7 ;Z-e a z By D E Executed on � z1%Z gy DATE Executed on By DATE nt and to the best of my knowledge the information contained herein is true and complete. I certify under atthe foregoing S-VL.1e and correct. SIGNATURE : CANDIDATE, OR STATE MEASURE PROPONENT SIGNATURE OF IRATE, 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.Rov (866/275-3772) www.fppc.ca.Rov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER Headding for Mayor 2024 11411645 All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREACODE/PHONE BANK ACCOUNT NUMBER Pacific Premier Bank 805-995-4355 ADDRESS CITY STATE ZIP CODE 898 Morro Bay Blvd Morro Bay CA 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. • 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. ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION Nonpartisan Partisan (list political party below) Nonpartisan Partisan (listpolitical party below) Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) 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 Il Alrl I InG nICTUIrT— 1-1 1% John Headding Mayor, City of Morro Bay SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 410 (August/2018) FPPC Advice: advice@fdpc.ca.gov (866/275-3772) www.fppc.ca.gov