?i . . Statement of OrganIzation Recipient Committee initial Not yet quali?ed I: or Statement Type Amendment List l.D. number: ORIGINAL COPY Termination See Part 5 List l.D. number23_] 2016 I SEP Date quali?ed as committee Date quali?ed as committee Date of Termination (if applicable) RECEIVED AND FILE lnthe theof?ce of the Secretary otS {Stat of the State of Caiifomia; Date Stamp CALIFORNIA 44 For Official Use Only _1 as; 30 2016 1. Committee Information NAME OF South Bay Families for Affordable College?Yes on STREET ADDRESS (NO PO. BOX) 2. Treasurer and Other Principal Officers NAME OF TREASURER Rita Copeland STREET ADDRESS (NO PO. BOX) STATE ZIP CODE AREA STATE ZIP CODE AREA CODEIPHONE Sacramento CA 9584 1 - Sacramento CA 95841 - MAILING ADDRESS (iF DIFFERENT) NAME OF ASSISTANT TREASURER, lF ANY FAX I ADDRESS STREET ADDRESS (NO PO. BOX) (916) 348?9111 campaigns@rcbs .us COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE CITY STATE ZIP CODE AREA Sacramento San Diego County NAME OF PRINCIPAL Humberto Peraza . . . . . . . STREETADDRESS NO Po BOX Attach additional Information on appropnately labeled continuation sheets. STATE ZIP CODE AREA CODEIPHONE 9" Verification have used all reasonable diligence in preparing this statem penalty of perjury under the laws of the State of Californi he'foregoin and to the best of my knowledge the information contained herein is true and complete. I certify under true and correct. Executedon 9/27/2015 By 2 DATE ATURE OF TREASURER 0R ASSISTANT TREASURER Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT Executed on 3] DATE SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE, OR STATE MEASURE PROPONENT Executed on 3/ DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (Jan12016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE 410 Page 2 of 4 COMMHTEE NAME LD.NUMBER 13905 7 South Bay Families for Affordable College?Yes on 8 2a. Additional Officers NAME OF OTHER PRINCIPAL NAME OF OTHER PRINCIPAL Nora Vargas MAILING ADDRESS MAILING ADDRESS SMTE EPCODE AREACODEWHONE CRY SMTE UPCODE AREACODBPHONE MAILING ADDRESS MAILING ADDRESS CRY SMTE EPCODE AREACODEWHONE CWY SMTE EPCODE AREACODEWHONE NAME OF OTHER PRINCIPAL NAME OF OTHER PRINCIPAL MAILING ADDRESS MAILING ADDRESS CWY SMTE EPCODE AREACODEWHONE CWY SMTE HPCODE AREACODBPHONE NAME OF OTHER PRINCIPAL NAME OF OTHER PRINCIPAL MAILING ADDRESS MAILING ADDRESS CITY STATE ZIP CODE AREA CITY STATE. ZIP CODE AREA FPPC Form 410 (Jan12016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME South Bay Families for Affordable College?Yes on . All committees must list the ?nancial institution where the campaign bank account is located. 41 0 Page 3 of 4 ID. NUMBER 1390587 NAME OF FINANCIAL INSTITUTION Community 1st Bank ADDRESS 2250 Douglas B1vd., Ste.190 4. Type Of committee Complete the applicable sections. caair'aii?a committee . List the name of each controlling Officeholder, candidate, or state measure proponent. It can district number, if any. and the year of the election. AREA BANK ACCOUNT NUMBER (916)724v2424 CITY Roseville CA . List the political party with which each Officeholder or candidate is affiliated or check "nonpartisan." 95661 didate or Officeholder controlled, also list the elective office sought or held, and If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. NAME OF MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY Nonpartisan Nonpartisan 'Primaril Formed Committee Primarily formed to support or oppose speci?c candidates or measures in a single election. List below: NAME OR FULL TITLE (INCLUDE BALLOT NO. OR LETTER) OFFICE SOUGHTOR HELD OR JURISDICTION (INCLUDE DISTRICT No, CITY OR COUNTY. AS APPLICABLE) CHECK ONE bond measure to upgrade the college&146;s infrastructure and security, build new state~ofuthe?art classrooms and facilities, Measure Southwestern Community College SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 410 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME South Bay Families for Affordable College-Yes on 4.Type of Committee (Continued) ?General Not formed to support or oppose speci?c candidates or measures in a single election. Check only one box: CITY Committee [1 COUNTYCommittee [j STATECommittee Page 4 of 4 ID. NUMBER 1390587 BRIEF DESCRIPTION OF ACTIVITY List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO. AND STREET CITY STAT ZIP CODE {j I Date quali?ed 5. Termination Req uirements By signing the verification, the treasurer, assistant treasurer and/or candidate, Of?ceholder, 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 ?led all campaign statements required by the Political Reform Act disclosing ail reportable transactions. -- There are restrictions on the disposition of surplus campaign funds held by elected of?cers who are leaving of?ce 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 (Janl2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772)