Laserfiche WebLink
Statement of Organization STATEMENT OF ORGANIZATION <br />Recipient Committee <br /> <br />iNSTRUCTIONS ON REVERSE <br /> <br />4. Type of Committee <br /> <br />l"""'x'~"l~""'Z*I"~'B~"/"l"lt'l~'-- ~.~°rmedt°sup~pec~flccandi~a sot measures ina single election. Check only one.x: <br /> <br />P EBRIEFDESC TPTION FACTIVI~ <br /> <br /> List additional s~n~m on an a~chment. <br /> <br />~E OF SPONSOR INDUS~Y GROUP OR AFFILIATION OF SPONSOR <br />S~EET ADDRESS NO. AND STRE~ C~ STA~ ZIP CODE <br /> <br />Bk3t ~ ~IENiT~/~ ''~r~ ~"1~ ~ ~ln ~ ~l-m [] I I Check box end provide the date this committee qualified as a sm~l[ contributor committee. If the committee qualified as a small <br /> Date qualified contributer committee on January 1,2001, enter 1 I1/01. <br /> <br />S. Termination Requirements By s~gningtheved~catI~n`thetreasurer~ass~stanttreasurerand/~rc~ndid~te~ceh~der~rpr~p~nentcer~if~thata~fthef~wingc~nditi~nshavebeenmet <br /> This committee has ceased to receive contributions and make expenditures; <br /> <br /> · This committee does not anticipate receiving contributions or making expenditures in the future; <br /> <br /> · This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; <br /> <br /> This committee has no surplus funds; and <br /> <br /> This committee has flied all campaign statements required by the Poliflcal Reform Act disclosing afl reportable transactions. <br /> <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 /> <br /> -- Additional filing obiigaflons will be incurred if, after terminating, the committee receives or spends any funds, or receives the forgiveness of a loan, <br /> repayments of loans made to others, or any other receipts. <br /> <br /> FPPC Form 410 (Janl01) <br /> FPPC Toll-Free Helpllne: 866/ASK-FPPC <br /> <br /> <br />