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Statement of Organization <br />Recipient Committee <br />INSTRUCTIONS ON REVERSE <br />COMMITTEE NAME <br />Friends to Re Elect Alicia Aguirre for City Council 2011 <br />4. Type of Committee (Continued) <br />Leluu �e:/�illl/•1•tY��1UNlrrlfll�� Not formed to support or oppose specific candidates or measures in a single election. Check only one box: <br />CITY Committee ❑ COUNTY Committee E] STATE Committee <br />PROVIDE BRIEF DESCRIPTION OF ACTIVITY <br />e /7-Y G4vAlC/�- <br />h7•NNbY•Il�� List additional sponsors on an attachment. <br />NAME OF SPONSOR <br />INDUSTRY GROUP OR AFFILIATION OF SPONSOR <br />STATEMENT OF ORGANIZATION <br />CALIFORNIAi <br />FORM 41 <br />Page 3 <br />I.D. NUMBER <br />1276471 <br />STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE <br />i•7ur-/Il<h•.lr►t•i•j11►1j/1it:4Check 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 />5. Termination Requ i rementS By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that all of the following conditions have been met: <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 />Government Code Section 89519. <br />FPPC Form 410 (January/05) <br />FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) <br />