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AND FILED <br /> t Ct~ Cl .STATEMENT OF TERMINATION Intha4 k~oflh®~etmyofStafe <br /> ........ ot he Sim ~ ~1~ <br />  This form must be completed by candida[es, officeholders or <br /> ~ recipient committees [hat wish to terminate pursuant to <br /> Government Code Section 84214. :EB 0 4 1991 <br /> (Type or Prml ~n IIIk ) <br /> <br /> Form 41 5 ~ ~NG EU, ~ta~ of State <br /> 1990 IRECIPIENTCOMMI~EE TERMINATION.! A <br /> <br /> ~OMMI[TEES FILE ORIGINAL AND ONE COPY OF fills FORM WI[tt lite SECRE IARY Of StAIE AND, IF APPLICA~E~'~COPY WITH THE ~OCAL FILING OFFICER <br /> N~E OF CONMITT~E: <br /> <br />  CODE/DAY lIME PHONE NUMBER <br /> PERMANENT ADDRESS OF TREASURER: NO AN[) 5TR[ [ CIIY SIAIi ZIP CO()[ RHEA <br /> <br /> EFFECTIVE DATE OF TERMINATION: <br /> L /,;5~,"~/' VERIFICATION <br /> <br /> I HAVE USED ALL REASONABLE DILIGENCE IN PREPARING Tills STATEMENT. Tills COMMITTEE HAS CEASEO TO RECEIVE CONTRIBUTIONS ANO <br /> MAKE [XPENOlTURES, DOES NOT ANTICIPATE RECEIVING CONTRIBUTIONS OR REPAYMENTS OF OUTSTANDING LOANS MADE TO OTHERS OR ANY <br /> OTHER RECEIPTS OR MAKING EXPENDITURES IN THE FUTURE, ttAS ELIMINATED OR HAS DECLARED THAT IT ttAS NO INTENTION OR A~ILITY TO <br /> DISCHARGE ALL DEBTS, LOANS RECEIVED AND OTtlER OBLIGATIONS, ItAS NO SURPtUS FUNDS. AND HAS FILED ALL CAMPAIGN STATEMENTS <br /> REQUIRED BY THE POBTI~L REFORM ACT DISCLOSING ALL REPORTABLE TRANSACTIONS. <br /> <br /> I C[RTIF? UNDER PENALTY OF PENURY UNDER THE LAWS OF TIlE STATE OF CALIFORNIA THAT TIt[ EOREGOING IS TRUE AND CORRECT. <br /> <br /> EXECUTED <br /> / (DAT[I ICilY AND Slll[) OR STAT[ MEASURE <br /> EXECUTEDON AT BY ,, <br /> (DATEI I{IIY AND SIAT[I [~GNAIUR[ Of CONTROLtlNG CANDIDAIE. OFflCEtlOLDER OR STATE MEASURE PROPONENI) <br /> EXECUTED ON AT BY <br /> (DATE) (ClIY AND S[AIE) (51GNAIUH[ OF C~IROLtlNG CANOIDAIE. O~flCEHOLOtR OR STA~E MEASUH[ PROPONENT) <br />~jP2} :::::: ~E~F~::: ~ ~NDIDATE/OFFICEHOLDER TERMINATION I <br /> I ORIGINAL OF THIS FORM WITH THE FILING OFFICER WITH WHOM THEY FILE THE ORIGINALS OF THEIR CAMPAIGN <br /> <br /> OFFICE SOUGHT OR HELD flaCtuoE <br /> AND O~SlmCI NUMBER If APPLICABL~) <br /> <br /> RESIDENTfAL OR BUSINESS ADDRE SS: NO AaO SlMt[I CIIY SIAl[ ZIP CODE AREA <br /> <br /> /,/~ ,/'~/ VERIFI~TION <br /> <br /> I[{lll~[ Ol M~lI~6 [XPE~DI~U~[~ IN Ttt[ fU~[; H~V[ [LIMIN~[~ O~ HAVE DE~A~ED THAT I HAVE NO I~I[~TIO~ O~ ~ILI1~ TO <br /> <br /> I([R~IF~ U~D[~ PEN~L~ O~ PE~UR~ UN~[~ T~E LAWS.Of THE STA~[ Of ~LI[O~NI~ [1t~ TIt[ ~O~[6OIN6 I~ T~[ ~ <br /> <br /> EXECUTED <br /> [(II~AND~IAI[] ~ "-'' ~ G U [ Of ( NOD 1[O~ <br /> NOTE: ADDITIONAL FILING OBLIGATIONS WILL BE INCURRED IF A CANDIDATE OR COMMITTEE BEGINS RAISING O~ SPENDIN~ FUNDS OR <br /> RECEIVES THE FORGIVENESS OF A LOAN OR REPAYMENTS OF LOANS MADE TO OTHERS OR ANY OTHER RECEIPTS. <br /> <br /> FOR INFORMATION REQUIRED TO BE PROVIDED TO YOU PURSUANT FO TIlE INFORMATION PRA~ICE$ A~ OF 1977, SEE INFORMATION MANUAL ON <br /> CAMPAIGN DISCLOSURE P~OVISIONS OF TItE POL~ICAL HEFORM Act <br /> <br /> <br />