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410 DeLuna (08-30-18) Amendment_Redacted or Statement of Organization Date Stamp CALIFORNIA 41 0 Recipient Committee ` FORM Statement Type J Initial ] Amendment 0 Termination—See Part 5 AUGor Official Use Only Not yet qualified I1 30 2018 Of Cl1Y Ot —i6➢O ri hz 0 Date qualified as committee O R / 7 7 / 7 n 1 8 �_/ Y )(:' Date qualified as committee Date of termination pity Clerk l p l tm,'nt /— 1. Committee Information 11.D. Number I 2. Treasurer and Other Principal Officers (if applicable) 1408345 NAME OF COMMITTEE NAME OF TREASURER Yolanda Miranda Gabriel DeLuna for Chino Hills City Council 2018 NAME OF ASSISTANT TREASURER,IF ANY STREET ADDRESS(NO P.O.BOX) N/A CITY STATE ZIP CODE AREA CODE/PHONE DICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S) Los Angeles 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 prepari ntained herein is true and complete. I certify under penalty of perjury under the laws of the State Executed on 0 8/2 7/2 01 8 By h8/27tA.E018 Executed on By DATE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,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 41 0 Recipient Committee FORM INSTRUCTIONS ON REVERSE Page 2 Page 2 of 3 COMMITTEE NAME I.D.NUMBER Gabriel DeLuna for Chino Hills City Council 2018 1408345 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER California Bank & Trust ADDRESS CITY STATE ZIP CODE 4. 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 FIELD YEAR OF PARTY NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE City Council Member District 4 Nonpartisan Partisan (list political party below) Gabriel U. DeLuna 2018 X 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 SUPPORT OPPOSE FPPC Form 410(February/2018) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov Statement of Organization CALIFORNIA 41 0 Recipient Committee FORM INSTRUCTIONS ON REVERSE Page 3 Page 3 of 3 COMMITTEE NAME I.D.NUMBER Gabriel DeLuna for Chino Hills City Council 2018 1408345 4. Type of Committee (Continued) 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 , ienaa.a.IA.a,lulh ear 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 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(February/2018) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov