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Statement of Organization STATEMENT OF ORGANIZATION <br /> Recipient Committee � . - • , � <br /> . - <br /> INSTRUCTIONS ON REVERSE <br /> Page 3 <br /> COMMITTEE NAME I.D.NUMBER <br /> Committee to Elect Kevin Bondonno <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 /> ❑ CITY Committee � COUNTY Committee � STATE Committee <br /> PROVIDE BRIEF DESCRIPl10N OF ACTIVITY <br /> �• � •� � �� List additional sponsors on an attachment. <br /> NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR <br /> STREET ADDRESS NO.AND STREET CITY STATE ZIP CODE <br /> . • . • <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 /> rJ.T@YI'Y11111t1011 R@(�UIP@I'Yl@tlt5 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 bythe Political ReformAct 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 /> Govemment Code Section 89519. <br /> FPPC Form 410 (January/OS) <br /> FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772) <br />