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415 Termination ECIPIENT COMMITTEE Recipient Committee Statement of Termination This form must be completed by recipient committees that are eligible to terminate pursuant to Government Code Section 84214 WHERE TO FILE: Flte original and one copy of this form with: Secretary of State Political Reform Division P.O, Box 1467 Sacramento, CA 95812-1467 ~--' [~ ~_ ~-~ ~] ~ ~'~ SJ'~I~MENTOFTERMINATIOb Type or prtat In Ink, I Recipient Committee Information NAME OF COMMrrrEE RE ELEC? RICHARD LOWEN?HAL ADDRESS OF COMMI3-rEE 21602 VILLJ% MARIA COURT NO. AND STREET And, if applicable, file one copy of this form The city or county officer, if any, committee's campaign disclosure statements. CITY STATE ZIPCODE CUPERTINO CA 95014 AREACODE/DAYTIMEPHONENUMBER (408) 973-8494 II Treasurer Information I.D. NUMBER NAME OF TREASURER 1256061 TOM HALL III MAILING ADDRESS OF TREASURER NO. AND STREET 21040 HOMESTEAD RD CITY STATE ZiP CODE CUPERTINO CA 95014 AREA CODE/DAYTIME PHONE NUMBER (408) 773-1400 Effective Date of Termination DATE FILING OBEGATIONS WERE COMPLETED 12/31/2003 IV Verification A. This committee has ceased to receive contributions and make expenditures; B. This committee does not anticipate receiving contributions or making expenditures in the future; C. This committee has eliminated or declares that it has no intention or ability to discharge all debts, loans received, and other obligations; D. This committee has no surplus funds; and E. This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. I have used all reasonable diligence in preparing this statement. I have reviewed the E ~ R STATE MEASURE PROPONENT Executed on At By DATE CITY AND STATE SIGNATURE OF COHTROLUNG OFFICEHOLeER, CANDE)ATE, OR STATE MEASURE PROPONENT Executed on At By