|
TERMINATION
<br /> Statement of Termination Tv.. or Print In Ink.
<br /> This form musl bc completed by officeholders, candidates, and recipient commillees
<br /> Ihal wish to terminate pursuant Io Govcmmcnl Code Section 84214. / R E C E ! V ~ O
<br /> AND FILED , A For Ofliclal Uso Only
<br />
<br /> ........ ~i~-~ !I ~ :* In heafficeofthe$ecretaryo~Stato
<br /> , ~ ~ ~. ' of the State of California
<br />
<br /> OfFiceholders and candidates file an original of. this form with thc filing
<br /> whom they file thc originals of their campaign slalemcnts. ' ~% - 6 ~ :'"! '~-'· ~1~. 1 4 1992
<br /> Committees file an original of. this form with thc Secretary at Stale and. if' appli,
<br /> a copy with thc local filing officcr. I
<br /> I Officeholder or Candidate Termination i I ition
<br />
<br /> II Inlormalion on Office $oughl or Held II Treasurer
<br />
<br /> III Verification III Verification
<br /> i have used all reasonable diligence in prcpa~ing this statement. [ have ceased ~o receive I have used all reasonable diligence in preparing this statement. This conunittee ha~ ceased
<br /> con~bution~ and make expeaditu~; do not anticipate receiving contribulion~ or repaymenu of receive conlxibutlon~ and make expenditures; does not anticipale receiving conlHbafions or
<br /> ouatsnding ioen~ made m other or any other recciixs, or making expenditures in lira furore; repaymenm of ou~tandin8 loans made to others or any other receipts, or making expenditures in
<br />· -~ have elimina~d or decl~e that I have no intention or ability to dischuge all debu, Ioapa the future; hu eliminated or decides tha~ it hu no intention or ability to discharge all debts,
<br /> received, and other obligations; have no smplus funds; and have filed all campaign sta~ement~ loan~ received, and othe~ obligations; has no surplus funds; and has filed ali campaign
<br /> requi~ed by the Political Reform Act disclosing all reportable erensactions, meats requbed by d~e Political Reform Act disclosing all rcportsblc I~ansactions.
<br /> ! certify under Penalty of perjury under the laws of thc/~ate ~ California ~hat./l~e [oregoing..).'~ I certify under penalty of perjm7 under the laws of the/~tate/~ f Califor~ia/hat/~he .foregoingj. s
<br /> and o.ec, ...... ,, --,--- ,,, co,,ec=o
<br /> ~.cu,.d~., r I.--. ~ : 1 ~' ~.9. Al 1/ ~ ~ . ~ ~,,e~on ...,,.~.._.~ DATE .- ,~ ..,,, . Al ~. ,,-.,.I~,~,,~, ,----,~ .,'~' '"_/
<br /> ~--~z,
<br /> I/l/ - Da"II. 6'.~'~_. _ ._// o....A. / /
<br /> Executed onDATE Al 'c~w n~o ~ATE
<br />
<br /> By
<br /> ~GHATI. Jfl~ OF cOI4TRO4.UNO OFFk~r.~O LOEq, C/b'~K~OATE. O~ STATE M EASIII~
<br />
<br /> Execut(~:l on Al
<br /> DATE ~ITV aJ~ STAIE
<br />
<br /> By
<br /> · GNATUflE OF CC)HTROLUNG OFFICEHOLDER, CAHDIDATE. Off STATE UF..~ugE
<br />
<br /> ~ Execuled on Al
<br /> NOTE: Additional tiling obllgalJons will be incurred it an officeholder, candidate, or commlllee DATE ow,~o STATE
<br /> i begins raising or spending funds or receives Ihe forgiveness of a loan or repayments of
<br /> loans made to others o~ any other receJpIs. By
<br />
<br /> FOR INFORMATIOR RECiUIRED 1'O lie PROVIDED 1'~ YOU PURSUANT 1'O THE INFORMATIOH PRACTICES ACT OF 1977, SEE JNFORMA'flON MANUAL ON CAMPAIC~N DISCLOSURE PROVISIONS OF 1tIE POi II'ICAI l~
<br />
<br /> Slate el Califernla F&le Pelil!¢al P~a¢li¢®e Commlaalen.
<br />
<br />
<br />
|