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410 Amendment Statement of Organization Recipient Committee STATEMENT OF ORGANIZA 1lO'J ----1----1_ Date qualified as committee # 1289527 08/12/2006 ----1----1_ Date qualified as committee (If applicable) # Date Starn Type or print in ink Statement Type o Initial Not yet qualified 0 or [RJ Amendment List 1.0. number: o Termination - See Part 5 List 1.0. number: ----1----1_ Date ofTermination NAME OF COMMITTEE 2. Treasurer and Other Principal Officers NAME OF TREASURER 1. Committee Information YES ON MEASURE E, TO SUPPORT GOOD GOVERNMENT, SCHOOLS, THE LOCAL ECONOMY AND ENVIRONMENTALLY FRIENDLY HOUSING, WITH MAJOR FUNDING BY TOLL BROS., INC. MR JASON D. KAUNE STREET ADDRESS STREET ADDRESS (NO P.O. BOX) 591 REDWOOD HIGHWAY, #4000 591 REDWOOD HIGHWAY, #4000 CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE MILL VALLEY, CA 94941 NAME OF ASSISTANTTREASURER, IF ANY 415-389-6800 MILL VALLEY, CA 94941 MAILING ADDRESS (IF DIFFERENT) 415-389-6800 MR SEAN P. WELCH STREET ADDRESS 591 REDWOOD HIGHWAY, #4000 CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 415-389-6874 COUNTY OF DOMICILE MILL VALLEY, CA 94941 NAME AND POSITION OF OTHER PRINCIFl'.L OFFICER(S), IF APPLICABLE 415-389-6800 COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE MAILING ADDRESS MARIN SANTA CLARA CITY STATE ZIP CODE AREA CODE/PHONE Attach additional information on appropriately labeled continuation sheets. 3. Verification I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on I~ I " I , ~ By DATE Executed on By OATE Executed on By DATE Executed on By DATE www.netfile.com -?,. ASSISTANT TREASURER SIGNJ\fURE OF CONTROLLING OFFICEHOLDER, CANDIDllrE, OR STATE MEASURE PROPONENT SIGNJ\fURE OF CONTROLLING OFFICEHOLDER, CANDIDllrE, OR STATE MEASURE PROPONENT SIGNJ\fURE OF CONTROLLING OFFICEHOLDER, CANDIDllrE, OR STATE MEASURE PROPONENT FPPC Form 410 (Jan/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC Statement of Organization Recipient Committee STATEMENT OF ORGANIZATION INSTRUCTIONS ON REVERSE CALIFORNIA 41 0 : FORM COMMITTEE NAME YES ON MEASURE E, TO SUPPORT GOOD GOVERNMENT, SCHOOLS, THE LOCAL ECONOMY AND ENVIRONMENTALLY FRIENDLY HOUSING, WITH MAJOR FUNDING BY TOLL BROS., INC. I.D. NUMBER 1289527 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 or check "non-partisan." . If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. NAME OF CANDID..ofE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PAR TY I 0 Noo-P,,",," o Non-Partisan . List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE Primarily Formed Committee Primarily formed to support or oppose specific candidates ormeasures in a single election. List below: CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE SUPPORT OPPOSE MEASURE E CITY OF CUPERTINO X SUPPORT OPPOSE www.netfile.com FPPC Form 410 (Jan/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME YES ON MEASURE E, TO SUPPORT GOOD GOVERNMENT, SCHOOLS, THE LOCAL ECONOMY AND ENVIRONMENTALLY FRIENDLY HOUSING, WITH MAJOR FUNDING BY TOLL BROS., INC. 1289527 4. Type of Committee (Continued) General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box: o CITY Committee 0 COUNTYCommittee o STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY Sponsored Committee List additional sponsors on an attachment. NAME OF SPONSOR TOLL BROS. INC. STREET ADDRESS NO. AND STREET 250 GIBRALTAR ROAD INDUSTRY GROUP OR AFFILIATION OF SPONSOR HOME BUILDER CITY STATE ZIP CODE HORSHAM PA, 19044 Small Contributor Committee o ----1--1_ Check box and provide the date this committee qualified as a small contributor committee. If the committee qualified as a small Date qualified contributor committee on January 1,2001, enter 1/1/01. 5. Term i natio n Req u ire me nts By signing the verification, the treasurer, assistant treasurer and/or 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 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. -- Additional filing obligations will be incurred if, after terminating, the committee receives or spends any funds, or receives the forgiveness of a loan, repayments of loans made to others, or any other receipts. www.netfile.com FPPC Form 410 (Jan/05) FPPC Toll-Free Helpline: 866/AsK-FPPC Additional Comments for Form 410 STATEMENT OF ORGANIZATION INSTRUCTIONS ON REVERSE CALIFORNIA 41 0 FORM COMMITTEE NAME P age 4 of I.D. NUMBER 4 YES ON MEASURE E, TO SUPPORT GOOD GOVERNMENT, SCHOOLS, THE LOCAL ECONOMY AND ENVIRONMENTALLY FRIENDLY HOUSING, WITH MAJOR FlNDINQ!~2tDLL BROS., INC. ADDITIONAL ADDRESS: www.netfile.com FPPC Form 410 (Jan/05) FPPC Toll-Free Helpline: 866/ASK-FPPC