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RecipientCommittee WHERE TO FILE: ~/"~ ~/~c/'h :-~ RECIPIENT COMMITTEE <br /> STATEMENT OF TERMINATION <br /> Statement of Termination File original and one cop¥ of this form with: <br /> Date Stamp <br /> This form must be completed by recipient committees Secretary of State <br /> that are eligible to terminate pursuant to Government - Political Reform Division <br /> Code Section 84214. P.O. Bo~ 1467 <br /> Sacramento, CA 95812-1467 C[ t:".: ~:': ~ "' ¥:';";' For Official U~ Only <br /> <br /> commi~ee's campaign disclosure statements. <br /> <br /> I Recipient Committee Information II Treasurerlnformation <br /> NAME OF COMMITTEE ~I.D. NUMBER NAME OF TREASURER <br /> .~/. :.D-~ ~ ~ ~ ~,~"~~_. .O. ANDSTREET <br /> MAILING ADDRESS OF TREASURER <br /> ADDRES~F COrM TTEE ~ NO. ANO[~REET <br /> <br /> AREA CODE~AYTIME PHONE ~UMBER <br /> /~ / ~ ) ~' Y ¢ - ~ ~&' ~ / III Effective Date of Termination <br /> DATE FILING OBLIGATIONS WERE COMPLETED <br /> <br /> IV Verification <br /> A. This committee has ceased to receive contributions and make expenditures; <br /> <br /> B. This committee does not anticipate receiving contributions or making ex~nditures in the future; <br /> <br /> C. This committee has eliminated or declares that it has no intention or ability to discharge all debts, loans received, and other obligations; <br /> <br /> D. This committee has no surplus funds; and <br /> <br /> E. This committee has filed all campaign statements required by the Political Reform Act disclosing all reputable transactions. <br /> <br /> I hav~ ~sed all reasonable diligence in preparing this statement. I have reviewed the statement and to the ' <br /> here;n ~s true and complete. I cecil under enalt ' _ ..... b~st of my ~noTledge the ~nformation contained <br /> ~ Y p y of perjury under the laws of the State o~orn;a that t~ forego~ ~s true and corre~. <br /> <br /> DATE SIA~ <br /> SIGNATU~OF CONTROLLING OFFICEHOLDER, ~NDIDRTE. ~ STATE MEASURE PRO~E NT <br /> Executed on At <br /> DATE CItY AND STATE By <br /> SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASU~ PROPONENT <br /> Executed on At <br /> DAIE CITY AND STATE By <br /> S~NATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE, ~ STATE MEASURE PROPONEN1 <br />FOR INFORMA11ON REQUIRED 70 8f PROVIDED 10 YOU PURSUANT IO ~HF INFORMATION P~CTICES ACT OF 197~. SEE INFORMATION MANUAL ON CAMPA~G~ DISCLOSURE PROVISIONS OF [HE POLITICAl REFORM ACT <br /> <br /> State of California Fair Political Practices Commission <br /> <br /> <br />