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�t��:�r�Pnt of ����s�a��tio¢� e • - • , <br /> ���ip��a�t�����ett�� � _ � , <br /> INSTRUCTIONS ON REVERSE <br /> Page 3 of 3 <br /> COMMITTEE NAME I.D,NUMB[R � <br /> Committee to Elect Ernie Schmidt for Redwood City Council 2013 1357109 <br /> �ie:',�i��'R�����,%., , �;����,_., .,.'� . .. .. . . .. � ' ... . . . , .. . ,. .. . . .. . .. . <br /> � ' �� � Not formed to support or oppose specific candidates or measures in a single election. Check oniy one box: <br /> ❑ CITY Committee ❑ COUiUTY�ommittee❑ 57ATE Committee <br /> PROVIDE BRIEF DESCRIPTION OP ACTIVITV <br /> : <br /> �1 •• � ' �_IS�'c�(l�-1 t=nn-.!c;nC;�;.7 c !7;l.?tl �ttcll`E'rY1C'I;'�:. <br /> ,� _ <br /> -- ,._......._..____«.,.....�._,.n.........___�.._.�m r..___. <br /> NAME OF SPONSOti INDUSTRY GROUP OR AFFILIATION OF SPONSOR <br /> STREET ADDRESS NO.AN�STREET CITY STATE ZIP CODE �y�u�� <br /> � � � � � � <br /> � � <br /> Date qualiHed <br /> S.T�.'DtY711#'1�'I�74i1 REC�U�i"���1"1'� 8y signing the verificalion,the tl�eas�arer;assistant treasurer and/or candidate,officeholder,or prupc�nent r.ertify tha't a11 of the following�.o�iui�irn�s havr.L�.���met. ~ <br /> o This committee has ceased to receive contributions and make expenditures; <br /> • This commi�ee does not anticipate receiv�r�g co�tributions or making expei�d��ures ir�t"e 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 Refr�rm Act disclosing all reportabie Crarisactions. <br /> -- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving ofFcc and by defeated candidates. Ref�r t�G�vernment <br /> Code Section 89519. <br /> -- Leftover funds of ballot measure committees may be used for political,legislative or governmenta)purposes under Government Code Sections 89511-89518,and are <br /> subject to Elections Code Section 18680 and FPPC Regulation 18521.5. <br /> FPPCform 410(DecJ2012) <br /> FPPC Advice:advice@fppc.ca.gov(866/275-3772) <br /> www.fppc.ca.gov <br />