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Statement of Organization <br />Recipient Committee <br />Statement Type Xinitiall <br />Not yet qualified <br />or <br />Q Date qualified as committee <br />❑ Amendment ❑ Termination — See Part 5 <br />Date qualified as committee Date ofite mm� atlon <br />'---/ <br />WL - <br />D. NNJE--umber <br />(if applicable) <br />NAME OF COMMnTEE <br />SEAN THOMAS FOR BREA CITY COUNCIL, 2018 <br />STREET ADDRESS (NO P.O. BOX) <br />BREA <br />E-MAIL ADDRESS (REQU I RET+) /FAX (OPTIONAL) <br />COUNTY OF <br />ORANGE <br />TATE ZIP CODE <br />CA 92821 <br />TION WHERE COMMITTEE 15 <br />OF BREA <br />Attach additional information on appropriately labeled continuation sheets. <br />I have used all reasonable cmigence In pr <br />penalty of perjury under the laws of the <br />Executed on — BI <br />DAT <br />Executed on a <br />ATE <br />this ctatPment and to <br />Date SsamP <br />JAI. <br />OFFICE OF THE <br />CITY CLERK <br />THOMAS DANIEL LONG <br />Fbr official Use Onlp <br />CITY - DIAIt ar W.. ........, .._.._ <br />BREA CA 92821 <br />NAME OF ASSISTANT TREASURER. IF ANY <br />STREET ADDRESS (N4 P.O. 9410) <br />CITY STATE ZIP CODE AREA CGDE/PHONE <br />NAME OF PRINCIPAL OFFICER(S) <br />SEAN THOMAS <br />STREET ADDRESS (NO RO. BOX) <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />BREA CA 92821 <br />my knowledge the information contained i'erein is true <br />Executed onDATE BY SIGNATURE OF CONTROLLING OFFIC€ROLDER, CANDIDATE. OR STATE MEASURE PROPONENT <br />Executed on By <br />DATE 51GNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (October/2017) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />