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410 HART 24-0605_RedactedStatement of Organization Recipient Committee Walemem7ype ,, tnhrl� Not yet qualified or City Council 2024 Amendment threshold STREET ROOPF55 NORe.BOq cm MATE nemvs AREACOWPHII San Juan Capistrano CA 92675 FULL MWYNOARORESS IIF DIFFERENT E' MAIL ADDRESS IREOUIR ED)t FAX(09IONALI EOUNTYCF DOMIDILE JOI NDNMNWNEREmMMMWKACFW Orange San Juan Capistrano Attach addloonal Information on appropriately labeledcundnuaean sheets. the Name 2 24 Jiit•! -7 AN 10: 13 Data oftworloanon =i YCI�" 2. Treasurer and OtherPrindeal Officen Cynthia Russell STREET ROSAMUND AD. Arj. OIY SiRIE ni WOE PPERCORaFNORP San Juan Capistrano CA 92675 - 14ME OI iSfIETYRIRFREURF41FPH'/ aw RAN Le OODE AR APPOU LIORE STRUTACORLSS NO AD RMD D WV STATE avcOoe PRMOODnFNONE OIOWEeOon By DATE SIGNMURE OFCONIFOLLA4 OFAEENOLOER faEDIDATrOR SM" Mmun PRO40NENF ExeaEtedon By DATE SIGNANREOF LONTROLUNG OFEIEENOEDER. OAMWD E ORSMTE MEASURE ABUNDANT FPPC Form 410 )Ausug/2018) FPPCAdulm adwim@(pl:.Da.raa (866/275.3772) WtOW.fpPe.Ca.gOV Statement of Organization Recipient Committee INSTRUCTIONS ON REVEmE City Council 2024 All mmmMees must list the financial lnsUkMm where the campaign bank account Is looted. Fanners and Merchants Bank _.—. ____ ADDRESS STATE NeoJDD 91873 Del Obispo Street San Juan Capistrano CA 92675 • 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. • Ust 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 CANDIOATUOFFICENOLOEPJSTATE MWORE PROPONENT EIECTIVTRICT ESMUGHi0PNE10 YOU OF MRTY IINCLUOE06TRFFICE BOUGRTCAHELD IF YOUON rmwrmp Primarily formed to support or oppose specific Candidates or measures Ina single election. Llst below: CANOIOATEIS)NAME OR MEASUREISI FULLTmE (INCWDE BAUM NO. OR U=ER). CANDIOATEIS) OFFICE SOUGHT OR HELD OR MMUMS)JURISDICTION .... n.............� ...�....... rnv... ....nvvvr�mww....n..n. n.aw......�...a.....�..... ..n�........�..........�....�, CX0.TOXf Nonpamian RMACRI (rigpolllkalparrybelow Howard Hart Gly Councilmember 2024 � nnpamsan Damson (aSt paaNW party below) Primarily formed to support or oppose specific Candidates or measures Ina single election. Llst below: CANOIOATEIS)NAME OR MEASUREISI FULLTmE (INCWDE BAUM NO. OR U=ER). CANDIOATEIS) OFFICE SOUGHT OR HELD OR MMUMS)JURISDICTION .... n.............� ...�....... rnv... ....nvvvr�mww....n..n. n.aw......�...a.....�..... ..n�........�..........�....�, CX0.TOXf WPPDA FROM SI^❑oI� L__J GIPf❑l lJ FPPC Fmm 420(August/1018) FPPC Advice: a IWce@Fppeo.gov (8G0/27a}37R) www.fppR.o.gnv Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Hart for SJC City Council 2024 PROVIDE BRIEF DESCRIPTION OF ACTIVITY Not formed to support or oppose specific candidates or measures In a single election. Check only one box: ❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee List additional sponsors on an attachment. —/. — I MM Walified SjerminatbgRequirements Byslgningthe.verification, the treasurer, assisianttreasurer and/or candldatecfflieholder, or I a following wndItIons have been met: • This committee has ceased to receive contributions and make expenditures, T • 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 flied 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@fppc.m.gov (866/275-3772) www.fppc.ca.gov