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Margaret Clark - 410- ; §f, � \ , �Ole \ \ \ z\ E �R k ) §\ m � k ` a \ $ / § \z/}. . 0E Li e !\§\ 5tateme t t organization Date Stamp - CALIFORNIA _ , Recipie t ommittee 410 _ M Statemen Ty a ❑initial El Amendment ® Termination — See Part 5 For Dfficial Use Only Q Not yet qualified or O Date qualification threshold met Date qualification threshold met Date of termination 01 13 2022 • • • I.D. Number 1392530 • • if applicable) NAME OFC MMI TEE OF TREASURER Comm' ee to Re-elect Margaret Clark to Rosemead City Council 2017 711AME ulie Gentry TREET ADDRESS (NO P.O. BOX) STREETADESS NO P.O. Box) CITY STATE ZIP CODE AREA CODE/PHONE Rosemead CA 91770 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Rosemead CA 91770 FULL MAILIP G AD KESS (IF DIFFERENT) STREET ADDRESS (NO P.O. BOX) E-MAIL ADD IESS( EQUIRED)/FAX(OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE COUNTY OF OMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S) STREET ADDRESS (NO P.O. BOX) Attach c ddi ional information on appropriately labeled continuation sheets. CITY STATE ZIP CODE AREA CODE/PHONE l nave urea all reasonable diligence in preparing this sl penalty of erjurrJ1y under the laws of the State of Califo Executed n ` S v �Lry;1 � By DAT nent and to the best of my knowledge the information contained herein is true and complete. I certify un that the f9r5going is Sue and correct. , hIRtASURER UR ASSIS IAN I I REASURER Executed n = - 112 Z.- By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed Executed UAIL By By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410(August/2018) FPPC Advice: advice( fppc.ca.eov (866/275-3772) www.fDPc.ca.¢ov Statement of Organization Recipie CALIFORNIA 410 t ommittee _ I M INSTRUCTIONS ON ' IEVERSE Page 2 COMMITTEE NA E I.D. NUMBER Committee t Re-elect Margaret Clarlc to Rosemead City Council 2017 1392530 • All com ni ees must list the financial institution where the campaign bank account is located. NAME OF FINA CIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNTNUMBER ADDRESS CITY STATE ZIP CODE Type Committee4. of • • applicable Secti• each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled, ctive office sought or held, and district number, if any, and the year of the election. T1heof al party with which each officeholder or candidate is affiliated or check "nonpartisan." Stating "No party preference" is acceptable ee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. NA E Of ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IFAPPLICABLE) ELECTION CHECK ONE Margaret I larlL City Council Member, Rosemead 2022 Nonpartisan Partisan (list political party below) 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: CANIDA E(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(5) JURISDICTION IF /, 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: advice9fuac.ca.¢ov (866/275-3772) www.fopc.ca.gov r�ost�,rnEl� tatement of Organization I STATEMENT OF ORGANIZATION Type or print In Ink :ecipient Committee p �;.n�,(;:jved h� Date Stamp CALIFORNIA Lo >vr; ael< . • 1 atement Type ❑ Initial Amendment ❑ Termination —See art y. , of )la �al�'F,f`� Not yet qualified ❑ or List I.D. number: List I.D. number: in 11 office of the SeCretp c:f a � 3 9 � � G # 2MB J ;' I 0 P,`1 'Q: 3 3 D ^^^ of the state of C8140rnia Z, � _7 nnlvi r. F-T, nra I DEC 0 3 2007 Date qualified as committee Date qualified as committee Dale of Term' r� x•.f%' S ��• �' f� (if ePP�mble) DO u ,j „. v tG 16EBRA BOWER Committee Information 2. Treasurer an t —er'Pnn oretary oir $783 NAME OF COMMITTEE NAME OF TREASURER Ce07rylr'A7 '4 el"l 4'L13E IZ-rq D. LAwLeErr 1/2a_2 "x /i�rK STREET ADDRESS -' STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS (IF DIFFERENT) OPTIONAL: FAX/ E-MAIL ADDRESS COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE /D-7 �ln�f���5 Attach additional intonation on appropriately labeled continuation sheets. STREET ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE Verification 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 ZZ - O % DATE Executedon 07 DATE Executed on Executed on By By _ U Q­ i VMCV�VVNIHVLUNGU "IULHULDER, CANDIDATE, OR STATE MEASURE PROPONENT By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT FPPC Form 410 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275-3772) atement of Organization Dcipient Committee itement Type ❑ Initial Not yet qualified ❑ or Dale qualified as committee Committee Information NAME OF COMMITTEE Type or print in ink [5 Amendment List I.D. number: u Date qualified as committee (I( aypl'cebis) ❑ Termination — See List I.D. number: Date of Termination c"'')YIA7Ye-a- it Rc3- e4lecf /'! a_'- a r-z-t Cl _r_l< STREET AD DRESS (NO P.O. 60X) CITY STATE ZIP CODE AREA CODE/PHONE c5rll ���C CA ?/770 IF DIFFERENT) OPTIONAL: FAX /E- MAILADDRESS STATEMENT OF ORGANIZATION Date Stamp For Official Use Only OED FI 2. Treasurer and Uther nnc NAME OF TREASURER 4L _G�GR -rq B. L(-I WLt?F STREET ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE r U5 EY7-lE AD c_P 91-7`76 NAME OF ASSISTANT TREASURER, IF ANY STREET CITY STATE ZIP CODE AREA CODE/PHONE NAMEAND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE COUNTY OF DOMICILE COUNTY WHERE COMMITTEE 15 AC nvE lr Ulrrcncnl THAN COUNTY OF DOMICILE MAILING ADDRESS ,a =} An q e 1— -5 . STATE Attach additional information on appropriately labeled continuation sheets. AREA CODE/PHONE Verification I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained her 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 // - //' C) % By OF TREASURER OR ASSISTANT TREASURER Executed on �� — �/" 07 ( BY '�` -�'� OFFICEHOLDER, CANOIUATE, OR STATE MEASURE PROPONENT Executed on Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT By SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE OR STATE MEASURE PROPONENT FPPC Form 410 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275-3772) ttement of Organization CITY Off" PCC? E.f1.�EAD Type or print in ink cipient Committee Ni0V 01. 2001 lement Type ❑ Initial ❑ Amendment ❑ Termination - See Part 5 Not yetqualilied® Or List 1.D. number. List 1.D.nr4TV r;I F?- 1 47 OI=r'C( A N Dale qualified ascommillee Dale qualified as committee Dale of Termination III applicable) Committee Information NAME OF COMMITTEE c//7 v/Yl r%') iW;Q ti h lee —d&cf ��CCI G�s2ru� C�urk - - STREET.A'DDRESS (NO PA. BOX) ' CITY MAILING ADDRESS (IF OPTIONAL: FAX /E -MAIL ADDRESS STATE ZIP CODE AREACODE/PHONE COUNTY OF DOMICILE I COUNTY WHERE COMMITTEE IS ACTIVE THAN COUNTY OF DOMICILE Attach additional information on appropriately labeled continuation sheets. Treasurer and Other Principal Officers NAME OF TREASURER MAILING ADDRESS IF ANY , STATEMENT OF ORGANIZ. only AREA CODE/P CITY - STATE ZIP CODE AREA CODE/F NAME AND POSITION OF OTHER PRINCIPALOFFICER(S), IF APPLICABLE MAILING CITY STATE Verification 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. perjury under the law of 1 e State of California that the foregoing is true and correct.' Executed on « i d Oy DATE SIGNATUR2EOFTREASURERORA ISTANTTREASURER Execuledon BY % OFFICEHOLDER, CANDIDATE, OR STATE MEASURE Executed on Executed on DATE AREACODE/I I certify under pens BY SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE. OR STATE MEASURE PROPONENT By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 41 For Technical Assistance: 916/3 >tatement of Organization tecipient Committee JSTRUC1 IONS ON REVERSE G. Type of Committee Complete the applicable sections. STATEMENT OF Page 2 • List the name of each controlling officeholder, candidate, or stale measure proponent. It candidate or officeholder controlled, also list the elective office sought or held, district number, it 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 IF APPLICABLE) YEAR OF ELECTION PARTY NO ,t ('�zrk �un nveMG�� �1.5e�/ea .1001 Non - Partisan `l r it Non - Partisan List the financial institution and the disposition of surplus funds (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION AREACODE/PHONE BANKACCOUNTNUMBER DATE OPENEI ,/ ,erict r%. man G2ir) 53-51•/0a 5�a l, ADDRESS CITY STATE - ZIP CODE DISPOSITION OF SURPLUS FUNDS 6A 91 z113-1—coe) 1:17 =- /l7IZ7-77j7T,&qTiiTU7hl Primarily formed to support or oppose specific candidates or measures In a single election. List below: CANDIDATE(S) NAME OR MEASURE(S) URE(B) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INCLUDE YISTRICT NO., CITY OR COUNTY, AS APPLICABLE) FPPC Form 4 For Technical Assistance: 9161 'u 'a ', V. I V. V, yN„1L"l IWI I =clpient Committee e 1' vernmenl Code Sections 64101- 84103) REC�.� A� amendment CITY OF'PO� ] Check box It an Amendment and enter I.D. number: If AUCTIONS ON REVERSE Committee Information late Qualified as Committee _ JUT! 0 1997 /O 7(A Dale SlaMp WHERETO FILE: { 1 444 File original and one copy with- Secretary fff��� ///��� A cal Ref State � I P L1 1 C 7\ cD�D MD FIf Political Reform Division I. v H r CAL F[F.D��,I Di Sac Box 7467 F:rll c` QT SECP,ci /p t Sacramento, CA 85012 -1467 STATEMENT OF ORGAN]' If applicable, file one copy with:? JUN j 6 ^ . The city or county officer, if any, who receives the AN 10: Ayt, 9 CITY CLERK'S OFFICE committee's original campaign disclosure statements. ❑ Check box it not yet qualified tMonlh, Dag Yea, AME OF COMMITTEE vrr'rcL i�a�0�� eoM/'t(TTeC Fern, A-k r ciit,P, (�, )DRESS OF COMMITTEE (NOT P.O. BOX) NO. AND STREET 'PC) 5C- E/+-0 (2 A- -0S 4 NG'(- 4-5 STATE AREA CODE /PHONE NUMBF - THAN COUNTY OF DOMICILE BOX rY STATE ZIP CODE AREA CODE /PHONE NUMBER 2. Treasurer and ZF Oulclal P� ED �? 48 PM `97 L"fTeunc- NAME OF TREASURER MAILING ADDRESS C STATE ZIP NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /DAYTIME PHONI Attach addilional infomtation on appropriately labeled continuation sheets. lerification have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is frHP- and Cmmnlata nder penalty of perjury under the laws of the Slate of California Ihl cecuted on (Ei� `.7i X4'7 T/ DATE BY cecutedon By DATE :eculed on I '.Hi By SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE, OR STATE MEASURE PROPONENT ecuted on B Y DATE SIGNATURE OF CONTR LUNG OFFICEHOLDER, CANDIDATE, OR STgTE MEASURE PROPONENT 'ORMATION REWIRED TO BE PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT OF 1977, SEE INFORMATION M NUL ON CAMPAIGN DIS=51,7EE_PRO Ij1 Ma-9EjllE POLITICAL REFORM ACj, FPPC Form 410 (1 For Technical Assistance: 9161322 -! Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 2 4. Type of Committee: Complete the applicable sections. Controlled committee List the name of each controlling officeholder, candidate, or stale measure proponent. It candidate or officeholder controlled, also list the elective office sought or held, and district number, If any List the political party with which each officeholder or candidate Is affiliated. An officeholder or candidate not holding or seeking a partisan office must indicate 'non-partisan. If this committee acts (oinlly with another controlled committee, list the name and identification number of the other controlled committee. List the disposition of surplus funds. NAME OF CANDIDATE /OFFIC EHOLD ER/STATE MEASURE PROPONENT: OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) i PARTY Primarily formed to support or oppose specific candidates or measures In a single election. List below: CANDIDATE'S NAME OR MEASURE'S FULLTITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE'S OFFICE SOUGHTOR HELD OR MEASURE'S JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) Not formed to support or oppose specific candidates or measures In a single election. Check only one box: iI CITY Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY . Committee Category: Complete one or both categories, it applicable. Provide additional sponsors on an attachment. mne.vw nuumtbb: NO. AND STREET J IAIt )USTRY GROUP OR SPONSOR: ZIP CODE El COUNTY Committee ❑ STATE Commit) 8ma1l.;C0n1r1bu10r Committee ij Dale qualified as a small contributor committee (Month. Day, Year) (] No longer qualifies as a small contributor comm FPPC Form 410 For Technical Assistance: 916/32