Loading...
410 Friends Termination Statement of Organization Recipient Committee Type orprintin ink STJlfEMENT OF ORGANiZATION #úts-\\\7 ~--Ì-J~ Date of Termination Statement Type 0 Amendment List 1.0. number: ~ Tenmination - See Part Jl.);;t 1.0. number: 0 Initial Not yet qualified 0 or # -----1-----1- Date qualified as committee -----1-----1- Date qualified as committee (If.ppUœblo) 1. Committee Information NAME OF COMMITTEE ~~. c5\j)V'o lA~~ STREET ADDRESS (9 ~ c~~ ~ CITY STATE ""-.0" OPTIONAL, FAX I E-MAiL ADDRESS COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DiFFERENT THAN COUNTY OF DOMICILE Mach additional information on appropriately tabeled continuation sheets. 2. Treasurer and Other Principal Officers NAME OF TREASURER :f, <~~ STREET ADDRESS lCß(C) ~\)Q~~ ~. ~d~ (A'1Q)\<t- CITY STATE liP CODE' REACDDE/Pt-/ONE NAME OF ASSISTANT TREASURER. IF ANY STREET ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE NAME AND POSITION OF OTHER PRINCIF>\L OFFICER(S). iF APPLICABLE MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE I certify under penalty of 3, Verification I have used all reasonable diligence in preparing this statement and to OR STATE MEASURE PROPONENT OATE Executed on Bf SIGNArURE OF CONTROLLING OFFICEHOLOER. CANDIOArE. OR STATE MEASURE PROPONENT FPPC Form 410 (Jan/O3) FPPC TolI-F,.. H.loHn.' 866/ASK-FPPC Statement of Organization Recipient Committee STATEMENT OF ORGANIZATION INSTRUCTIONS ON REVERSE CALIFORNIA 41 0 FORM p' a, g. e. 2 COMMITTEE NAME h-lJ.:J DQ', M~~ , L <c.-l~ Ac-(è~ I.D.NUMBER q~l\ \, 4. Type of Committee Complete the applicable sections. Controlled Committee . 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 orcheck "non-partisan." . If this commillee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. ~;C--~ ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRiCT NUMBER IF APPLICABLE) YEAR OF ELECTION PAR TY NAME OF CANDIDAfE/OFFICEHOLDERISTATE MEASURE PROPONENT L~ CCA-...Y\G -..l Non-Partisan \C{95 0 Non-Partisan . Listthe financial institution where the campaign bank account is located (controlled "candidate election" committees only) w d;~ t4~&>~;07~ 6'+ £t.¡ CITY STATE ZIP CODE S. j)¿ ~ t~1 &¡zd;:W/ cf1 ?SV(7 BANK ACCOUNT NUMBER 0 ADDRESS I 0260 1iIlIJll¡UJJ,.""""",..."""",I"'" Primarily formed to support or oppose specific candidates or measures in a single election. List below: / CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTiON ~",~"~'OO;J(:'"" m"'~WŒ~~"o",m'", I ,"'"CO","'"'" ~""OO'OO~M,""O_' ~ FPPC Form 410 (Jan/OJ) FPPC Toll-Free Helpline: 8661ASK-FPPC Statement of Organization Recipient Committee STATEMENT OF ORGANIZATION CALIFORNIA 41 0 FORM p. a, g, e. 3 INSTRUCTIONS ON REVERSE h~ A~ I.DNUMBER qS'll\l )\ General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box: 0 CITY Committee 0 COUNTY Committee 0 STATECommittee PROVIDE BRIEF DESCRIPTI~JrAVITY x Sponsored Committee List additional sponsors on an attachment. NAME OF SPONSOR ~ A INDUSTRV GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO. ~ND STREET CrTY STATE ZIP CODE A 0 -----1-----1~ Check box and provide the date this committee qualified as a small contributpr committee. If the committee qualified as a Date qualified small contributor committee on January 1. 2001, enter 1/1/01. 5. Termination Requirements By signing the verification, the treasurer, assistant treasurer andlor candidate, officeholder, or proponent certify that all of the following conditions have been met: , This committee has ceased to receive contributions and make expenditures; . This commillee does not anticipate receiving contributions or making expenditures in the future; , This commillee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; , This commillee 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. Government Code Section 89519. Refer to FPPC Form 410 (Jan/O3) FPPC Toll-Free Helpline, 866/ASK-FPPC