BARNEICH, KRISTEN - FORM 410 - AMENDMENT (Stamped by SOS) 1.
-'Statement of Organization , :.{. ` Date Stamp = r
AFRNIA � •
. ` ®*Recipient Committee . .
Statement Type 0 initial `, (�p�(� r
��f Amendment 0 :Termination—See Part 5 �����v�D p^il`i l.! f��`�` For Official Use Only
Q Not yet qualified in the office of the Secretaryof ate
or of the State of California
0 Date qualification threshold met Date qualification threshold met • '.- Date of termination JULO �� t�
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✓---,� 6 /21___/ 2020 /
1 orprnt ee Ir,ferrrratlon I.D. Number 1426688 �, * °2 :Treasurer and Other Principal Officers • •
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NAME OF COMMITTEE 'NAME.OF TREASURER
Committee to reelect Kristen Barneich Arroyo Grande City Council 2020 ;=Brittany Bersbach —
STREET ADDRESS(NO P.O.BOX)
^�STREET ADDRESS(NO P.o.BOX) CITY STATE ZIP CODE AREA CODE/PHONE
:::: Arroyo Grande CA 93420
CITY , STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY
Arroyo Grande; CA 93420
FULL MAILING ADDRESS(IF DIFFERENT) ' '' ' .STREET ADDRESS(NO P.O.BOX)
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E-MAIL ADDRESS(REQUIRED)/FAX(OPTIONAL) 1 CITY STATE ZIP CODE AREA CODE/PHONE
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COUNTY CF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S)
San Luis Qbispo Arroyo Grande - - :'Kristen Barneich
- STREET ADDRESS(NO P.O.BOX)
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CITY STATE ZIP CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets. .:,`
Arroyo Grande CA 93240
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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.the laws of the State of California that the foregoing is true and.correct.
Executed on (Q\24\7b 7..c By • .
Executed on I I Byi� .....40....61161,
DATE SIGNATURE OF COLLING OF '-OLDER,CANDIDATE,OR STATE MEASURE PROPONENT
Executed on By, _._. . . .
SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
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• ,''-i-';,C;"•:.';;:_;,•:', ',DATE:;; SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
FPPC Form 410(August/2018)
FPPC Advice:advice(a(fppc.ca.gov(866/275-3772)
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www.fpoc.ca.gov
Statement of Organization ,CALIFORNIA
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1 0
Recipient Committee .FO�RMVL `' '
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D.NUMBER
Commitee to reelect Kristen Barneich Arroyo Grande City Council 2020 1426688
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION - AREA CODE/PHONE BANK ACCOUNT NUMBER
Mechanics Bank I 805)473-7710
ADDRESS CITY STATE ZIP CODE
1026 E Grand - Arroyo Grande . CA 93420
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• List the name of each controlling officeholder,candidate,_or_state_measure_proponent.___If_candidate or.officeholder.controlled,
_
:also list theaelective 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 CHECK ONE
Kristen Barneich City Council 2020 Nonpartisan Partisan (list political party below)
Nonpartisan Partisan (list political party below)
tPrnfrg.lJ rFoF,n`d 4/p, riittrref, a Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S)NAME OR MEASURE(S)FULL TITLE(INCLUDE BALLOT(NO.OR LETTER) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION
IF A RECALL,STATE"RECALL"IN FRONT OF THE OFFICEHOLDER'S NAME. (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.eov
Statement of Organization •cALIFDRNIA
Recipient Committee `" FORM • 41 0 ; .
INSTRUCTIONS ON REVERSE
Page 3
COMMITTEE NAME I.D.NUMBER
Committee to reelect Kristen Barneich Arroyo Grande City Council 2020 1426688
...', 4 Type of Commiiteet. (Continued). r4a .. - "x r w.. .. ... _ e...�ee�v' '., ,...0_ •. ; .?t'��r '..}.
General'eurposeComrnittee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
0 CITY Committee ❑ COUNTY Committee 0 STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY J ��
V5Rettilseiti*IiiartiMe:4414 List additional.sponcors on an-attachment.
NAME OF SPONSOR INDUSTRYGROUP OR AFFILIATION OF SPONSOR --
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STREET ADDf:ESS - NO.AND STREET CITY STATE 7IP CODE AREA CODE/PHONE
79 yy;�,y,,S�,c}Jn}�7 ,N�.Q `°�Q.t4"tix'i' . -:$e! ❑ ..
Date qualified
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W ,# $ n' A��rifi Ptt n le l? • • S'� �!`0,41t 1 f b :So(yioi lTl candi'5�..i s.hav ' e.�i►�?
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• This committee has ceased to receive contributions and make expenditures;
• 'This committee does not anticipate receiving contributions or making expenditures in the future; `
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.
— There are restrictions on the disposition of surplus campaign funds held by elected officers who areleaving office and by defeated candidates. Refer to
Government Code Section 89519. I
— 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:adviceftfp c.ca.gov(866/275-3772)
• www.fppc.ca.gov