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Home My WebLink AboutCarter, Tony J. - 2012 FPPC Campaign Disclosure Forms For 20 (2) Statement of Organization STATEMENT OF ORGANIZATION Type or print in ink Date Stamp Recipient Committee Statement Type ,initial ElAmendment El Termination—See Part 5 201 OCT ! 4 ! pitV.qeOnly Not yet qualified [ur or List I.D.number: List I.D.number: � sel Date qualified as committee te qualified as committee Date of Termination (If applicable) 1. Committee Information 2. Treasurer and Other Principal Officers NAME OF COMMITTEE NAME OF TREASURER IJ oat Cl �G IGCC/ STREETADDRESS(NO P.O.BOX) C 160W G.Yprg �a1� STREETADDRESS(NO P.O. CITY STATE ZIP CODE AREA CODE/PH NE 161 ��` � �crK� fJ �l��g Beni �a6 y q zr� gasio� CITY STATE ZIP CODE AREA CODE/PHONE NAME OFASSISTANT TREASURER,IF ANY 7 J� STREET ADDRESS(NO P.O.BOX) MAILING ADDRESS(IF DIFFERENT) 'JGCe CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/E-MAILADDRESS L T Gt � J`uJ ��vlNllJtrf/®� C®l� NAME OF PRINCIPALOFFICER(S) COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE STREETADDRESS tt(NO P.O.BOX) CITY p p STATE ZIP CODE AREA CODE/PHONE Attach additional information on appropriately labeled continuation sheets. „p�lyt5ty„�� ref ft /`if G�a�� 7 3. Verification 111 �11��`v"`r vw (� I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained her ' 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 y�l 1 By DATE STANT TREASURER Executed on n fR By _ DATE- pF�eON ER CANDIDATE,OR STATE MEASURE PROPONENT Executed on lI /0-7 By `DATE �" GN4LIJRE-OF CONTROLLING OF CEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on < ^j( _�� By DATE ,,.�" SIGNATURE OF CONTROLLING OFFICEHOL ER,CA DIDATE,OR 6TA MEASURE PROPONENT FPPC Form 410 (April/2011) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee ® . INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D.NUMBER C-4 027 6�6rpe6l( C2:!�l 4.Type of Committee Complete the applicable sections. 0 0 •. o • 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"non-partisan." • 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 NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT / (INCLUDE DISTRICT NUMBER IIF�APPLICABLE)) YEAR OF ELECTION PARTY � 5 7�,1<7 /ntN lr(j�K E f"IkC U l��f�Ct� �1"6 4, aq o_ Non Partisan ❑ Non-Partisan List the financial institution where the campaign bank account is located(controlled"candidate election"committees only) NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANKACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE 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 (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 410 (April/2011) FPPC Toll-Free Helpline: 866/ASK-FPPC (8661276-3772) Statement of OrganizationSTATENIENTOFORGANIZATION Recipient CommitteeAL.1iFORNIA FOR10 INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D.NUMBER 4.Type of Committee (Continued) •e e Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY •. e -. e List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREETADDRESS NO.AND STREET CITY STATE ZIP CODE e • a e ❑_J_J Date qualified 5.Termination Requirements By signing the verification,the treasurer,assistant treasurer and/or candidate,officeholder,or proponent certify that all of the following conditions have been met: • 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 (April/2011) FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772) Officeholder and Candidate FOn Type or print in ink. Date Stamp Campaign Statement— Short Form (Government Code Section 84206) Date of election if applicable: E] Amendment (Explain Belo lFor Official Use Only /l 1' Statement Covers Calendar Year 20��_ . 2. Officeholder or Candidate Information 3. Office Sought or Held NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD STREET ADDRYSS JURISDICTION(LOCATION) DISTRICT NUMBER AREA CODE/DAYTIME PHONE NUMBER OPTIONAL FAX/E-MAIL ADDRESS 4. Committee Information List all committees of which you have knowledge that are primarily formed to receive contributions or to make expenditures on behalf of your candidacy. COMMITTEE NAME AND I.D. NUMBER COMMITTEE ADDRESS NAME OF TREASURER ' 5' Verification |declare under penalty of perjury that hu the best of my knowledge I anticipate that I will receive less than$1,000 and that I will spend less than$1,000 during the calendar year and that I have used all reasonable diligence in preparing this statement. |certify under penalty of perjury under the laws cf the State cfCalifornia that the foregoing io true and correct. Executed on By DATE NATURE~'OFFICEHOLDER~^~~'`~~~ ^ pppc Form 4rmwro Supplement (Januan/mx) pppn Toll-Free *e|vnnn: oaomon'pppu (useoro-urru) CANDIDATE INTENTION STATEMENT Candidate Intention Statement Type or Print in Ink. Date stamp Check One: R I, C a For Official Use Only Initial ❑Amendment (Explain) ] I -e t f t lit; `�43 W0 Candidate Information: NAME OF CANDIDATE (Last,First,Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER(optional) E-MAIL(optional) 6Akl7ens -703t4 (°M) 996 S�®R , agy444igq9 '�wkyoaoq- wit STREET ADDRESS CITY STATE ZIP CODE OFFICE SOUGHT(POSITION TITLE) AGENCY NAME �y DISTRICT NUMBER,if applicable. NON-PARTISAN ,A M+ -e,. - 4> 'Ale— L—i A 6WAC16 Nu 1 h4 L1 6 PARTY: OFFICE JURISDICTION ❑ State (Complete Part 2.) y ,?City ❑ County ❑ Multi-County: (Name of Multi-County Jurisdiction) (Year of Election) 2. State Candidate Expenditure Limit Statement: (CaIPERS and CaISTRS candidates,judges,judicial candidates, and candidates for local offices do not complete Part 2.) (Year o/Election) Primary/general election (Year of Election) Special/runoff election (Check one box) ❑ I accept the voluntary expenditure ceiling for the election stated above. ❑I do not accept the voluntary expenditure ceiling for the election stated above. Amendment: O 1 did not exceed the expenditure ceiling in the primary or special election held on: and I accept the voluntary expenditure ceiling for the general or special run-off election. (M,aik if applicable) ❑ On / J I contributed personal funds in excess of the expenditure ceiling for the election stated above. 3 Verification: I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on � /y /��t Signature ilonth,day.year) (Candidate) FPPC Form 501 (Apri1I2011) FPPC Toll-Free Helpline:866/ASK-FPPC(8661275-3772)