HomeMy WebLinkAbout062122 Form 410A Burke 2022Statement of Organization
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Recipient Committee
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StatementType E] initial ® Amendment
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I.D. Number
2. Treasurer and Other
Principal Officers
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NAME OF COMMITTEE
NAME Oi ipINSURER
David Burke for City Council 2022
Jour Barcelona
STREET ADDRESS TRO PLO. BOY)
STREET Ess ENO P.O. BOX)C
ITY
STATE
aP CODE AREA CODePNONE
Fullerton
CA
92835
CDC STATE DECODE AREA CODePHONF
NAME OF ASSISTANT TREATABLE ANY
Fullerton CA 92835
Tammi McIntyre
TOLL MMLING ADDRESS III DIFFERENTI
57REET ADDRESS (NO F.O. BOR)
A MAIL 4LUCUIRFDE/FAX IOPOONAO
CTY
SPITE
Zi>COOE DL/'NONE
Fullerton
CA
92835
couuTYOFOOMICUF
AWRISUTTON WHERE COMMITTEE 15 ACTIVE
NAME OF PRINCIPAL OFF MALTA
Orange
City of Cypress
STREET ADDRESS (NO P.O. BON)
Attach additional information on appropriately labeled continuation sheets.
CITY STATE
TIP CODE AREA CODE/PHONE
penalty of perjury under the laws of the
Executed on o61H1z2 B
DATE
ExeauvEd on "�' B
DATE
Executed on By
DATE GERIATRIST OF CONTROLLING OFFICEHOLDER CANDIDATE, OR STATE MEASURE PROPONENT
Executedon By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Farm 410(August/2018)
FPPC AdviceadvireYlfooc ca cov )866/225-3772)
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Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Xanpartion
Partisan
)list potheal party below)
COMMITTEE NAMED
Council Member, City of Cypress -
NUMBER
David Burke for City Council 2022
14�4Q 38
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION�PHCOOEryxOxE
BANK ACCOUNT ARM FEE
ADDRESS CITY
STAR BY
Nonpiman
Fullerton
CA 92832
4. Type of Committee Complete the applicable seciftons.
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 theck"nonpartisanP 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/OFFICFHOLOER/STAGE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
Primarily farmed to support or oppose specific candidates or measures in a single election. List below:
N AME OR AEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATELSI OFFICE SOUGHT OR H ELO OR MEASURFBI JURISDICTION
C"TATE RECALL I N FRONT OF THE OFFICE HOLDER'S NAM E, (INCLUDE DISTRICT NO., CITY OR COUNTY AS APPLICABLE] CRECx OME
FEW Fori (AUgast/2018)
III Advice: adatiosiooc Dv(SM/1753)72)
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Xanpartion
Partisan
)list potheal party below)
David Edward Burke
Council Member, City of Cypress -
2022
Nonpiman
Parr an
Inst pollMal parobelow)
Primarily farmed to support or oppose specific candidates or measures in a single election. List below:
N AME OR AEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATELSI OFFICE SOUGHT OR H ELO OR MEASURFBI JURISDICTION
C"TATE RECALL I N FRONT OF THE OFFICE HOLDER'S NAM E, (INCLUDE DISTRICT NO., CITY OR COUNTY AS APPLICABLE] CRECx OME
FEW Fori (AUgast/2018)
III Advice: adatiosiooc Dv(SM/1753)72)
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