*CpnStmt Stangel, W 830675 - Laserfiche WebLink

Browse Search

TERMINA%ON ; Statement of Termination Type or Print I. Ink. DaleSlamp This form must be completed by officeholders, candidates, and recipient committees thatwishtoterminatepursuanttoGovernmentCodeSection84214. [~ ~ ~ ~ A ForOffi¢ia~UseOnlv Officeholders and candidates file aa original of this form with the filing officer with FEB I 0 1992 whom they file the originals of their campaign statements. Committees file an original of this form with the Secrelary of State and, if applicable, a copy with Ihe local filing officer. I Officeholder or Candidate Termination I Recipient Committee Termination MAMa OF OFFIGEHOLDER OR CdLNDID&TEi -,7-- ~ /-' , , I I.D. NUMBER flESID~HTIAL Off BU~NESS ADDFI£S~: ~ (NO. ANOSTflEET).; ADDflESSOFCC~IIdlTTEE:~ (HO. ANOSTREET) CITY ~ / /*,~ STA"yE'/ . ZIPCOC~ CITY .~ II Inlormation on Offico/$ought or Held II Treasurer Inlormation g ;~.* C~ / z/ /*?~'2 ~ ~ / NAMS OF TRUBURERI LOCATION (F APPUCABLE) I DISTRICT NUMBER (IF APPUCABLE) PEflMAI~NT ADDflESS OF TREASUflEfl: (NO, AND STREET) Cl ' . STAFF ZiP - .. AREACOOEJDAYTIMEPHOt~NUMBER //I EFFECTIVI~DATEOFTERIdINMIC~J: III Verification III Verilicalion ] have used all reasonable diligence in prcpariag this slalcmcnt. ! have ceased to ~cccive ] have used all reasonable diligence in preparing this statement. This committee has ceased 1o contributions and make expenditures; do not anticipate receiving con~btuions or repayments of receive contributions and make expenditures; docs not anticipate receiving contribbtions or · _~ outstanding loan~ made lo others or any other receipts, or making expenditures in the future; repayments of outstanding loans made Lo others or any other receipts, or making expenditures in have eliminated or declare that I have no intention or ability to discharge all debts, loans the future; has eliminated or declares that it has no intention or ability to discharge all debts. : received, and other obligation.s; have no surplus funds; and have filed all campaign statements loans received, and other obligations; has no surplus funds; and has filed all campaign state- required by thc Political Reform Act disclosing all reportable uansactions, ments required by the Political Reform Act disclosing all reportable u'ansactions. I certify under penalty of perjury under the laws of thc State of California that the foregoing is I certify under penalty of perjury under the laws of the State of California that the foregoing is vS~I~NATURE'~B. Me~t~Ji'D-RCa,'~D~,~TE / I S~NATUREOFTRE. aSURER Executed on Al · By SK)NATURE OF (X)NTROLUNG OFFCF~O~DER, CAND~OATE, OR STATE IM F..a.SURE PROPONENT Execuled on At By NOTE: Additional filin9 oblioatlons will be incurred if an officeholder, candidate, or commltlea Executed on Al beolns ral~ln9 or spandin9 funds or receives the forgiveness of a loan or repayments of . loans made to others or any other receipts. By ' I FOR INFORMATION REQUIRED TO BE PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT OF 1977, SEE INFORMATION MANUAl ON CAMPAIGN DISCA OSURE PROVISIONS OF THE POLITICAL REFORM ACT. State et Calilornla Fal~ Pelllicel Practicee Commission.