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410 stamped from state Statement of Organization Recipient Committee 45 I J Of 'I r /1 Type or print in ink Cate StaTp Statement Type Mlnitial Not yet qualified cg/or RF D Termination - See Part m the List I. D number o Amendment List I D number: # fEB 0 5 Z007 # ----.1--1_ Date qualified as committee ---....J----.l_ Date qualified as committee r f applicable) ----.l Date of Termination 1. Committee Information 2. Treasurer and Other Principal Officers STATEMENT OF ORGANIZATION ,~ t';'i\a \JA VE COO COM\/I-E:: ~AM:: CF -~::ASLR::R /-1 GLfGI/ k"y AN GiLBEIlT VV<..1Ncr Fo ~ c I T'I {C'{)/IICI L 1(')78> fl:1/V//1/JIIICA.e Av~ S-RE::- ACC~=:SS sn=:ET ACC~::SS (~O PC 3CX) I () } 85" reM Iv' >~ L-IJR. Ail!:. Cd- Z " CCCE r ;'0 I? !'.REA CC)E/"rC~=: #(11) 733- 3 '/6/ CI-Y (.' IIltj7L///VO ~AI\tE 0" ASSIS-A \J- -REAse ~=:~. I" A \JY 6'/t-SG.e7 W,.rJ!r S-A-E C TV STAE ctr Z " CCCE 9501'+ AREA CC)E!"rC~=: tlld!) 3/ ~ ~ 8t/ 3'& LV 1'€~7/;1/0 Vi, _I~G AC)"ESS :1" C ""::~=:\J-) )079> le/V/NJIt'vA<- Av~ S-RE::- ACC~::SS CI-Y Cv/e-;el/#i/ S-.~,-E ?#- t '/111) 3/6- 9 iJ.J J OPTIONAL: FAX; E.MAIL AJJRESS (l..foiJ }25"-/22/ Z " CCCE JSt/IIt AREA CC)E/"rC~:: COJ~ TV CF COM C _E CCl\J YV'Jr=R=COVVITTE= SAC VEI=CF=::R=~ TrA~ COL \J-Y CF CCMICll:: ~AM::A\J) "CS - O\J CF O-.,E~ "RI~C "A_C"FICER(S) I" A"Pl CA3l:: J' /)/Y-;'I- C t...~M MAil ~G ACC~::SS cr-y S-AE A~::A COC::/P.,O\JE Attach additiona/lnformatlOn on appropriately labeled continuation sheets. ZIP CO):: 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 cenlfy under penalty of perjury under the laws of the State of California that the foregoing is true and correct Executed on / - ]() ~ 07 By J~"r:: Execu led on By C.;\,T:= Executed on By '-''':'T~ Executed on By C,t.,""'=- ~~ ' ~ ~ ST,AI E vlE...lS..JR=. PR~::;'Oi\='\J"'" s G.'J,A: ~~:::. 2F :::Cr-,;""'~OL:.J(\JG CFFICEf-JOlDER ~~ ';:;iJ~-t OR S:~-E VEAS,-IR=. :)q88C~IE\JT S G'\JA-'~RE OF co~ I ROLL NG OFFICEt-<OLDER CA,ND OATt: OR STAT:: iV1E:AS.JRE ='R8PO\k.NT FPPC Form 410 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Statement of Organization Recipient Committee STATEMENT OF ORGANIZATION \JsnJCTIC'JS C~ REV::RSE CALIFORNIA 41 0 FORM COVTvlTT =E \jA VE 61J...B>et<-7 f/l(jjVG C \j.JMBE~ FrJ /z, L/1/ (OIlNC/ 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 or check "non-partisan" · If this committee acts Jointly with another controlled committee list the name and identification number of the other controlled committee 'lAME 0= CA \jC JA-E/O"F CErCLC=~IS-A-E v ::ASJR:: "~CPC\JE~- ::_=CT VE OF"IC:: SOJG.,T CR .,ELC {I\jC_JCE C ST~ICT \jlllf13=~ = A""_ CA3_=) Y::A~ CF ELEC-IO\j PAR-Y G/i{j?f<.,7 elff Co V1/VC II.. 2- ~~ 7 ~ Non.Partisan LJ Q' /'I Cr D Non.Partisan · List the financial Institution where the campaign bank account IS located (controlled "candidate election" committees only) \lAVE OF FI~AI\C AL ~STITL O~ W15LLJ FM' CJ 8,4dl< A"EA COJ=/PrC~E BA\j<ACCCl~ \jJMBE" {~!~ 5"2.3- lo 00 8flG/:ibtJ/c:J8 A)JR::SS 23()OO floP>~Jfeil-1 f(ptJ. / CI-Y (.' (/I'W"//V(J STA-E C4 ZI" coc= f5~j'l Primarily formed to support or oppose specific candidates or measures in a single election List below CA~C JATE;S) \lA\!E CR MEASJ"E;S; =JL_ TlTL:: (I~C_l):: BA_LO- \lC CR _ETTER) CA \JJICATE;S; CFF C:: SCJGI-T C~ r=LJ OR V::ASLR::(S) JJRISJICTlC\j :1\lCLJCE JIST" C- ~C , C -Y CR CCl~ -Y, AS A"P _ICAS_E) - C.",=CK ONE I '""'" I "'''' SUPPORT OPPOSE FPPC Form 410 (January/OS) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/215-3772) Statement of Organization Recipient Committee STATEMENT OF ORGANIZATION \JsnJCTIC\lS C~ REV::RSE CALIFORNIA 41 0 FORM COVM TT=E 'lAVE 4. Type of Committee (Continued) 0/ i..Sri'/!'" 1 Ud'N~ FOA- (/1'1 (()WVC- it... LJ I\LV3::R General Purpose Committee Not formed to support or oppose specific candidates or measures In a single election Check only one box: Eia CITY Committee D COUNTY Committee D STATE Committee "ROVIJE 3R EF CESCRIP- O~ OF ACT V-Y Sponsored Committee List additional sponsors on an attachment. \JAVE C= S"O~SCR I~CJS '<V GRCLP OR AFFIL ATlON 0= SPO\jSOR sn::ET ACC~::SS \10 ,"~C S-RE::- C TV S-ATE Z " CCC:: Small Contributor Committee o ----1----.1_ Check box and provide the date thiS committee qualified as a small contrioutor committee If the committee qualified as a Date qualified small contributor committee on January 1,2001, enter 1/1/01 5. Term ination Requ irements By signing the verification. the treasurer, assistant treasurer andior candidate, officeholder or proponent certify that all of Ihe 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 11 the future; . T'lis committee has el minated or has no intention or ability to discharge all debts, loans received and other obligations, Ths committee has no surplus funds, and . This committee has filed a'l campaign statements reqUired by the Po!'tlcal Refor,T Act disclosing all reportable transactions There are restnctions or the disposition of surplus campaign funds held by elecIed officers who are leaVing office and by defeated cand dates, Refer to Government Code Section 89519 FPPC Form 410 (January/OS) FPPC Toll-Free Hel pline: 866/ASK-FPPC (866/275-3772)