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Statement of Organization <br /> Recipient Committee <br /> INSTRUCTIONS ON REVERSE <br /> Page 3 <br /> PEOPLE FOR HOUSING NOT HIGH- RISES <br /> 4.Type of Committee {Continued) <br /> Nat formed to support or oppose specific candidates or measures in a single election. Check only one box: <br /> � CITYCommittee �COUNTYCommittee �STATECommittee <br /> PROVIDE BRIEF DESCRIPTION OF ACTIVITY <br /> List additional sponsors on an attachment. <br /> NAME OFSPONSOR <br /> INDUSTRY GROUP OR AFFILiATION OF SPONSOR <br /> STREET ADDRESS NO.AND STREET CITY STATE ZIP CODE <br /> � _J� Check box and provide the date this committee qualified as a small contributor committee. If the committee qualified as a <br /> Date qualified small contributor committee on January 1,2001,enter 1/1/01. <br /> rJ.T@I'I'T11t1atIOt1R@C�UIP@ITl@IItS Bysigningtheverification,thetreasurer,assistanttreasurerand/orcandidate,o�ceholder,orproponentcertifythatallofthefollowingconditionshavebeenmet: <br /> • This committee has ceased to receive contributions and make expenditures; <br /> • This committee does not anticipate receiving contributions or making expenditures in the future; <br /> • This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; <br /> • This committee has no surplus funds; and <br /> • This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. <br /> -- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to <br /> Govemment Code Section 89519. <br /> FPPC Form 410(Jan/03) <br /> FPPC Toll-Free Helpline:866/ASK-FPPC <br />