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Statement of Organization <br /> Recipient Committee <br /> INSTRUCTIONS ON REVERSE <br /> COMMITTEE NAME <br /> Friends of Jeff Gee for City Council 2009 <br /> 4.Type of Committee (Continued) <br /> Not formed to support or oppose specific candidates or measures in a single election. Check only one box; <br /> � CfTY Committee � COUNTY Committee ❑ STATE Committee <br /> PROVIDE BRIEF DESCRIPTI�N OF ACTIVITY <br /> STATEMENT OF ORGANIZATION <br /> I.D.NUMBER <br /> � ����� <br /> List additional sponsors on an attachment. <br /> NAME OF SPONSOR <br /> STREET ADDRESS N0.AND STREET <br /> CITY <br /> INDUSTRY GROUP OR AFFILIATION OF SPONSOR <br /> STATE ZIP CODE <br /> (� _�,_,► 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 /> 5.Te rm i natio n Req u 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 />