HomeMy WebLinkAbout2022.02.22_Ford_Form 410 AmendmentStatement of Organization
Recipient Committee
Statement Type [ Initial Amendment
Not yet qualified
or
Date qualification threshold met Date qualification threshold met
I.D. Number
(if applicable)
NAME OF COMMITTEE
Jen Ford for Morro Hay City Council lull
STREET ADDRESS (NO P.O. BOX)
5445 Madison Avenue
CITY
STATE ZIP CODE AREA CODE/PHONE
Date StaMP
❑ Termination — See Part 5
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
Sacramento
JURISDICTION WHERE COMMITTEE IS ACTIVE
City of Morro Bay
Attach additional information on appropriately labeled continuation sheets.
3. VQrlticatidn - - °.
I have used all reasonable diligence in preparing this statement
penalty of perjury under the lla7ws of the State of California that
2. Executed on IW 22 By
DATE
Executed on 2�1 1 LP /22z By
DATE
Date of termination
Denise Lewis
STREET ADDRESS (NO P.O. BOX)
5445 Madison Avenue
CITY
1
REGFLII use Only
City of Morro Bay
FEB 2 2 lull
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 CA 95841 (916)348-9100
NAME OF PRINCIPAL OFFICERS)
STREET ADDRESS (NO P.O. BOX)
cITY
STATE ZIP CODE AREA CODE/PHONE
nd to the best of my knowledge the information contained herein is true and complete. I certify under
SIG
RER
PROPONEN7
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.gov (866/275-3772)
wwwJppc.ca.gov
neifile.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
ADDRESS
2233 Douglas Boulevard, Suite 300
4. Type of Committee Complete the applicable sections.
AREA CODE/PHONE
(916)724-2424
BANK ACCOUNT NUMBER
CITY STATE 21P CODE
Roseville CA 95661
I.D. NUMBER
1444164
• 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 OF CANDIDATE/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:
CANDIDATE(5) NAME OR
MEASURE(5)
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
(INCLUDE DISTRICT NO., CITY OR COUIJTY, AS APPLICABLE)
CHECK ONE
SUPPORT DPPOSE
SUPPORT I OPPOSE
FPPCForm 410(August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
r�aaaw�x�
Jen Ford for Morro Bay City Council 2022
4a
Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee f ❑ COUNTY Committee ❑ STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
• .. • • • • List additional sponsors on an attachment.
NAME OF SPONSOR
STREET ADDRESS
NO.AND STREET
Date qualified
CITY
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
S.'TerminatiOnRegUlrementS By signing the verification, the treasurer, assistant treasurerand/orcandidate,officeholder,orproE
• 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
• 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.
Page 3 of 3
I.D. NUMBER
AREA CODE/PHONE
onditions 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 maybe 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