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HomeMy WebLinkAboutPAC Revised Statement of Organization 2013STATEMENT OF ORGANIZATION OFFICE US k,VEt) OF POLITICAL COMMITTEE SEP City ° 2013 (PLEASE TYPE) Cjt� C /E, k S D�aR 1. Full Name of Committee Telephone Sebastian Citizens Speak Out 772 - 713 -7350 Mailing Address (include city, state and zip code) 973 Oswego Avenue Sebastian, FL 32958 -5133 Street Address (include city, state and zip code) 973 Oswego Avenue Sebastian, FL 32958 -5133 2. Affiliated or Connected Organizations (includes other committees of continuous existence and political committees) Name of Affiliated or Connected Organization Mailing Address Relationship n/a 3. Area, Scope and Jurisdiction of the Committee City of Sebastian 4. Nature of Organization or Organization's Special Interest (e.g., medical, legal, education, etc.) Issues effecting citizens in the City of Sebastian 5. Identify by Name, Address and Position, the Custodian of Books and Accounts (include treasurer's name) Full Name Mailing Address Committee Title or Position Michael A Goodfellow 1061 West Lakeview Drive Secretary/Treasurer Sebastian, Florida 32958 DS -DE 5 (Rev. 05106) (continued on reverse side) �M 6. List by Name, Address and Position, Other Principal Officers, Including Officers and Members of the Finance Committee, If Any (include chairman's name) Full Name Mailing Address Committee Title or Position Louise Kautenberg 973 Oswego Avenue Chair Sebastian, FL 32958 -5133 7. List by Name, Address, Office Sought and Party Affiliation Each Candidate or Other Individual that this Committee is Supporting (if none, please indicate) Full Name Mailing Address Office Sought Party Wright, Donald 720 N. Fischer Circle, Seb. City Council None Coy, Andrea 501 Palm Avenue, Sebastian City Council None McPartlan, Robert City Council None 8. List Any Issues this Committee is supporting: Issues benefitting Sebastian residents. List Any Issues this Committee is Opposing: Issues detrimental to Sebastian residents. 9. If this Committee is Supporting the Entire Ticket of a Party, Give Name of Party None 10. In the Event of Dissolution, What Disposition will be Made of Residual Funds? 11. List all Banks, Safety Deposit Boxes, or Other Depositories Used for Committee Funds Name of Bank or Depository & Account Number Mailing Address Suncoast National Bank 1110 Roseland Road 4327082781 Sebastian, Florida 32958 12. List all Reports Required to be Filed by this Committee with Federal Officials and the Names, Addresses and Positions of Such Officials, If Any Report Title Dates Required to be Filed Name & Position of Official Mailing Address None STATE OF Florida p Indian River p COUNTY Louise Kautenberg certify that the information in this Statement of Organization is complete, true and correct. Signatur f Chairman of P cal Committee Date