Statement of Organization Recipient Committee K Statement Type [¥initiat [DI Amendment [Di Termination = See Part § 1 Not yet uation DEC 12 2023 [O Date qualtication threshold mat [Date qualification threshold met] Dale of termination CALIFORNIA os eae a Dep REGISTRAR OF VOTERS: —— SPT accusam eT ys | —___p__ CM ence aemincl raked Robert Block Robert Block for Supervisor 2024 TTREET ADDRESS(NORO.BOH ar Tare a EOD Los Angeles Ca 90017 EMAIL RODRESS OF TREASURER (EQUIRED TEA CODETPVONE NAME OF ASSISTANT TREASURER, IF ARY a = £é+$s | any fe TP COOE_RRRACOORTPTORE NIA Los Angeles Cee av Tae ae TOLL WAIONG ADDRESS OPER NA TRAIT ADDRESS OF ASSSTANT TREASURER [REQUIRED] "AREA CODEFPIONE EHAIUADUNESS OF COMMITTEE REOUIRED]/ Ax (OPTIONAL) Iva Los Angeles [San Bernardino “STREET ADDRESS [NO PO. BORT ay ‘Ware CODE TRAIT ADDRES OF PRIPAL OFFICERS REGUAEOT TRERCODETFIONE Attach additional information on appropriately labeled continuation sheets. | have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. | certify under penalty of perjury under the laws of the " 107 scutes on executed on 1/07/25 bxacvted on By = z beecvted on By a ‘TET TRE GF COTATI NE OTRO, NOOR, STEMS POPOV 90C Form 10 (October/2023) FPPC Advice: advice@fnpc.ca.gov (866/275-3772) www fppe.ca.g0V‘Statement of Organization CALIFORNIA Recipient Committee poe aL) InsTRrioNS on REVERSE i Robert Block for Supervisor 2024 {All committees must list the financial institution where the campaign bank account is focated and the person(s) authorized to obtain bank records. THAVE OT FMANCIAL STITTTON AND PERSONS] AUTHORED TO ONIN BARK RECORDS REA cODET PHONE ean ACCOUNT HOMER N/A N/A N/A TOORESS OF FRONCILINSTIUTION av ware TP CoBE NIA eeu st the name of each controling officeholder, candidate, or state measure proponent. if candidate or officeholder controlled, also list the elective office sought ar held, and district number, Fany, and the year of the election, st the political party with which eachvofficeholder 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. ELecTIVEOFHCE SOUGHT oR WELD veanor mar NAME OF CANOIDATE/OFFICEHOLDER/SATE MEASURE PROPONENT (ONcLUBE DISTRICT NUNEBER IF APPLICABLE) flecron coer one Robert Block San Bernardino County Supervisor District 3.2024 | Sowarien [Prior | (itpattetpanyosne) v party | Taian | — er penSea pan DoaT Primarily formed to support or oppose specific candidates or measures ina single election. List below: (CANDIDATES) NAME OR MEASURE(S FULL TITLE INCLUDE BALIOT NOL OR LETTER) ‘ANDIOAT(S) OFFICE SOUGHT OR HELD OF MEASLES) JURISDICTION IPARECALL STATE"RECALE IV RONT OFTHE O*ACEHOLDERS HAM IincLUbe STRICT RO, CTY OR COUNTY, AS APPLICABLE] ccoxone PC Form 410 (October/2023) FPPC Advice: advice fppc.ca.eov (866/275-3772) ww, fopc.ca.govStatement of Organization Recipient Committee ome NN FORM 410 ome Robert Block for Supervisor 2024 Cie eed Not formed to support or oppose speci candidates or measures ina single election. Check ony one box: C cry committee 11 COUNTY Committee D state Committee List adalttona sponsors on an attachment. ‘meer noone Nom STREET a sae acon BAER CODEIPIONE Pema candidate ee ee ‘+ 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 committaes may be used for politcal, 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 (October/2023) PC Advice: advice@fppe.ca.gov (866/275-3772)