Gee 01-24-2013 Amendment 410 - Laserfiche WebLink

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Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee • � •' � � � . - INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D.NUMBER Re-elect Gee for City Council 2013 1315847 4.Type of Committee (Continued) �� • � Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY .. . •. . List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO.AND STREET CITY STATE ZIP CODE ' ' ' ' � �_� Check box and provide the date this committee qualified as a small contributor committee. If the committee qualified as a Date qualified small contributor committee on January 1,2001,enter 1/1/01. RJ.Term ination 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 heen met: • This committee has ceased to receive contributions and make expenditures; • This committee does not anticipate receiving contributions or making expenditures in the future; • This committee has eliminated or has no intention or ability to discharge all debts,loans received,and other obligations; • This committee has no surplus funds;and • This committee has fited all campaign statements required by the Political Reform Act disclosing all reportable transactions. -- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government Code Section 89519. FPPC Form 410(January/05) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)