BARNEICH, KRISTEN - FORM 410 - INITIAL Statement of Organization Date Stamp CALIFORNIA
Recipient Committee . • RECEIVED FORM , 4'1 0
Statement Type Initial 0 Amendment 0 Termination—See Part 5 For Official Use Only
) Not yet qualified M1AY 2 2029
or CITY CLERK'S
0 Date qualification threshold met Date qualification threshold met Date of termination CITY OF ARROYp FFIC:
GRANiE
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1. Committee Information I.D. Number 2. Treasurer and Other Principal Officers •
p I a• Ilcable -
NAME OF COMMITTEE ' III - -ee, --co NAME OF TREASURER
Pi C' CU'D d.1 Chi (. ? nct I i0 STREET ADDRESS(NO P.O.BOX)
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CIN STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY
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FULL ING ADDRESS(IF DIFFERENT) STREET ADDRESS(NO P.O.BOX)
E-MAIL ADDRESS(REQUIRED)/FAX(OPTIONAL)_" - CITY STATE ZIP CODE AREA CODE/PHONE.
i4O � � lrnalJURI
COUNT SDICTI WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S) .
• " San LuCs' ob o . f�rY�yo &Yz nct • 1- kn C� e��
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STREET ADDRESS(NO P.O.BOX) r
.
CITY STATE ZIP CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets. .1/4Nf
3. Verification j ; . -
I have used all reasonable diligence in preparing this statement and to t e 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 sI I V'SI 2020 By . `R L,
DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER
CAA
Executed on Si �� O 20 By \P6-Mitilik
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,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:advicet)fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA •41 o
Recipient Committee FORM -
I NSTRUCTI ONS ON REVERSE
Page 2
COMMITTEE NAME I.D.NUMBER
.1- I,•rnel al, A 0 o Strord6 CtiN Gancipm
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
I1eGIPOn i.CS 16an 1Z".' POS- 13 Lp0
ADDRESS CITY STATE ZIP CODE
IDA!) Dd. &r-rid h'ic . . haroD &(sainct C z. . q o 2D
..x . �i , 4
4. Type of Committee Complete the argplicabte sections. _• .
.i.
Controlled Committee .
• List the name of each controlling officeholder,candidate,or state measure proponent. If candidate or officeholdercontrolled,
also list the electiveoffice sought or held,and district number,if any,and the year of the election.
• List the political party withwhich 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
Nonpartisan Partisan (list political party below)
�3 barnekch Ciel Cenci l 121)2D
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:
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:adviceeofouc.ca.gov(866/275-3772)
www.fppc.ca.gov
•
`Statement of Organization CALIFORNIA 410� .. ° � -
Recipient Committee FORMS
INSTRUCTIONS ON REVERSE Page 3
COMMITTEE NAME I.D.NUMBER
C m tD ".R " K barnedCh G��n ou�c�
I
. Type of Committee (Continuedi f`'
General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
0 CITY Committee 0 COUNTY Committee 0 STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
sponsored Committee, ' List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO.AND STREET CITY STATE ZIP CODE AREA CODE/PHONE
•
•
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mall Contributor Committee 0 ___./.._____/____
Date qualified _ ,
... Termination Requirements 6y sigOng the verification,the treasurer,assistant treasurer and/or candidate,officeholder or•`(anent certify that all of the fQllowing'conditions have been mpt
• 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 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(Wfnpc.ca.gav(866/275=3772)
www,fopc,ca,soor