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410 with committee number Statement of Organization Recipient Committee Type or print in ink /2q 7012--1 2. Treasurer and Other Principal Officers ~AME OF TREASUR ,:,) Ii _EN"-Y vAfJ G STOEO!vssAO{yl'tt~ . Ave. CITY STATE ZIP CODE i-. (,{ "'t ~l)\O elf '{>01C{- ~;~;*-178~tg~R""J<Yt. ('ALl · , J STREET ADDRESS I 10 1.41- ~ LBJ CO E= Df<\'vt;: CITY STATE ZIP CODE C uP€;te 71 NO, CPr. q!j; lit- NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE J13 Statement Type f!(initial Not yet qualified Ii:f or o Amendment List 1.0. number: # I I Date qualified as committee I I Date qualified as committee (If applicable) 1. Committee Information NAME OF COMMITTEE -ALee:re..T ~. C-f./ t.J kR. Celt CtJONelL STREET ADDRESS (NO P.O. BOX) lol4 2 C,L~t!.()lC hR.' ~ CITY STATE ZIP CODE Lul)~t<-IiNO ~ CA. q~olLr MAILING ADDRESS (IF DIFFERENT) NA OPTIO~l6~~E: i e. t~mQ~~ Yt~ COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE Attach additional information on appropriately labeled continuation sheets. o Termination - See Part 5 List 1.0. number: # EC oi the th8~ state oi Cd ~~R ~6 20 DEBRA 80 i8cfet8I'Y 0 1----1_ Date of Termination ~ CODElPHONE 8-54Q:45/ AREA CODE/PHONE 4og-11{-17~ MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE 3. Verification I have used all reasonable diligence in preparing this statement and to the best of my knowledge the informatio perjury under the laws of the State of California that the foregoing is true and correct. -3 - 2.l- 2001 DATE -t- 3 - 2..( - :z..001 DATE --l- Executed on By Executed on By Executed on By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT DATE Executed on By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT DATE contained herein is true and complete. I certify under penalty of ~ MEASURE PROPONENT FPPC Form 410 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Statement of Organization Recipient Committee STATEMENT OF ORGANIZATION COMMITTEE NAME CALIFORNIA 41 0 FORM INSTRUCTIONS ON REVERSE c. eMU HI!. elf ~O()Ne,IL- I.D, NUMBER 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 CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY -!l LB~R..-r C. (! +l Ll e-rf CaLJNelL 2.067 ts' Non-Partisan o Non-Partisan · List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) . . NAME OF FINANCIAL INSTITUTION -S Ar<ONG- 5~ ~ziOrt 3~*3 AREA CODE/PHONE BANK ACCOUNT NUMBER UNION lHl€>-S4s-SL02 12.38b 5~o CITY STATE ZIP CODE S \ JlJ~i~AL~ c.-A. Cf4o~5 ADDR~. O. Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures 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 I '"""" 10'''''' SUPPORT "OPPOSE FPPC Form 410 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Statement of Organization Recipient Committee STATEMENT OF ORGANIZATION INSTRUCTIONS ON REVERSE CALIFORNIA 41 0 FORM COMMITTEE NAME A Lf3 c. C+Ju -r:o~ ~/-rv c:.OONC!..1 L I.D. NUMBER 4. Type of Committee (Continued) General Purpose Committee ~formed to support or oppose specific candidates or measures in a single election. Check only one box: I:!I CITY Committee 0 COUNTY Committee 0 STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY Sponsored Committee List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE 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 Date qualified small contributor committee on January 1,2001, enter 1/1/01. 5. Termination Requirements 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. FPPC Form 410 (January/OS) FPPC Toll-Free Helpline: 866/AsK-FPPC (866/275-3772)