HomeMy WebLinkAboutShawn Kumagai 410_Initial_06-13-2018_redacted Statement of Organization Date Stamp CALIFORNIA A 1 O
Recipient Committee RECEIVED FORM, `F
Statement Type ®initial ❑ Amendment ❑ Termination—See Part 5 For Official Use Only
• Not yet qualified .
or JUN 132018
OcDate qualified as committee / / / /
Date qualified as committee Date of termination CITY OF DUBLIN
•/ / CITY MANAGER'S OFFICE
i I.D. Number
11 _Committee Information 2; Treasurer and Other Principal Officers -
(if applicable)
NAME OF COMMITTEE NAME OF TREASURER
SHAWN KUMAGAI FOR DUBLIN CITY COUNCIL 2018 • SHAWN KUMAGAI
STREET ADDRESS(NO P.O.BOX)
STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY
MAILING ADDRESS(IF DIFFERENT) STREET ADDRESS(NO P.O.BOX)
E-MAIL ADDRESS(REQUIRED)/FAX(OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S)
ALAMEDA DUBLIN, CA SHAWN KUMAGAI ,
STREET ADDRESS NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
3 .'Verification, `. .
I have used all reasonable diligence in preparing this statement and to the best
CANDIDATE,OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
FPPC Form 410(February/2018)
FPPC Advice:advice @fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA 0
Recipient Committee FORM `+
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D.NUMBER
SHAWN KUMAGAI FOR DUBLIN CITY COUNCIL 2018
• All committees must list the financial institution where the campaign bank account is located. •
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
ADDRESS CITY STATE ZIP CODE
4 Typepf Committee „Complete the applicable sections,
Controlled Committee
• 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"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)
SHAWN NAO KUMAGAI DUBLIN CITY COUNCIL 2018
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
CI El
SUPPORT OPPOSE
FPPC Form 410(February/2018)
FPPC Advice:advice @fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization • CALIFORNIA
Recipient Committee FORM 410
INSTRUCTIONS ON REVERSE
Page 3
COMMITTEE NAME I.D.NUMBER
SHAWN KUMAGAI FOR DUBLIN CITY COUNCIL 2018
41TyPe of'Committee, (cantlnued) {
General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee❑ STATE Committee❑ Political Party/Central 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
Small Contributor Committee
El
Date quallfled
5
Requirements, By,signing the verification the treasurer,asslstant 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.
Clear Pa e 1 hrint FPPC Form 410(February/2018)
g !!! FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov