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COPY <br /> Statement of Organization DateStamp CALIFORNIA A 1 O <br /> Recipient Committee®Initial ,. <br /> ❑ Amendment ❑ Termination—See Part FORM '+ <br /> Statement Type 5 l�' _a( ' For Official Use Only <br /> 0 Not yet qualified JUL 31 2018 <br /> or <br /> 0 Date qualified as committee Off�t�ti��/ <br /> —/—/ i,�; i it 3 <br /> Date qualified as committee Date of termination <br /> City Clerk's Department <br /> 1. Committee Information 11.D. Number I 2. Treasurer and Other Principal Officers <br /> (if applicable) <br /> NAME OF COMMITTEE NAME OF TREASURER <br /> Yolanda Miranda <br /> Gabriel DeLuna for Chino Hills. City Council 2018 <br /> NAME OF ASSISTANT TREASURER,IF ANY <br /> MAILING ADDRESS(IF DIFFERENT) STREET ADDRESS(NO P.O.BOX) <br /> • <br /> N/A <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S) <br /> STREET ADDRESS(NO P.O.BOX) <br /> CITY STATE ZIP CODE AREA CODE/PHONE <br /> Attach additional information on appropriately labeled continuation sheets. <br /> 3. Verification <br /> I have used all reasonable diligence in prepa n contained herein is true and complete. I certify under <br /> penalty of perjury under the laws of the Stat <br /> Executed on 7/26/2018 By <br /> DATE <br /> Executed on 7/26/2018 By <br /> DATE <br /> SURE PROPONENT <br /> Executed on By <br /> DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT <br /> Executed on By <br /> DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT <br /> FPPC Form 410(February/2018) <br /> FPPC Advice:advice@fppc.ca.gov(866/275-3772) <br /> www.fppc.ca.gov <br />