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9~f'~f~/~j RECIPIENT COMMITTEE <br /> ,.~..~.~,~,,,...w , -.~TATEMENT OF TERMINATION <br />Recipient Committee WHERE TO FILE: b I~ i '~ §~ce ~t~rl~n <br />Statement <br /> of <br /> Termination <br /> ~ ~ File orlginalandonecopyof this formwith: ~ 0~C0 0 ~h~ <br /> State <br /> ' ~1 Secretaryof State 0f the State 0t <br />This form must be completed by recipient committees ~ Polftical Reform Division <br />that are eligible to terminate pursuant to Government Po. Box 1467 For Official U~ Only <br />Code Section 84214. Sac~ame.to.C*~SS~-,46~ ~JAN 2 5 1995 <br /> Type or print in ink. And. if applicable, file one copy of this form with: <br /> The city or county officer, if any. who ~eceives the <br /> commi~ee's campaign disclosure statemenU. BILL J0~E8, Sao~eta~ el Stale <br />I Recipient Committee lnformation II Treasurerlnformation <br /> NAME OF COMMITTEE I.D. NUMBER NAME OF TREASURER <br /> <br /> ~2~ r/~ C~'~ MA~I,~ AD ESS OF TREASU.:. ,O. A,O STRE ET <br /> ADDRESS OF COMMITT[E ND. AND STR[[~ /~' ~/~ <br /> <br /> ,?/ <br /> A~ CODE~AYTI~E PHONE NUMBER <br /> (~/ ~ ~/ III EffectiveD.teofTermin.tion <br /> DATE FILING OBLIGATIONS WEHE COMPLETED <br /> <br />IV Verificn~ion A. Thls committee hns Censed ~o reCeive con~ribution~ nnd mn~e exDendi~ures; <br /> B. This Committee does not nnticiDn~e reCeiving contributions or ranking exDenditures in the future; <br /> <br /> C. This committee hns eliminnted or declnres ~hn~ it hns no intention or nbili~y ~o dischnrge nil debts, Ionns received, nnd o~her oblign~ions; <br /> D. This committee hns no surplus funds; ,nd <br /> <br /> E. This Committee hns filed nil c~mpnign s~n~ements required by ~he Poli~icnl ~eform Act disclosing nil reDo~nble ~r~ns~c~ions. <br /> <br /> I have used all reasonable diligence in preparing this statement. I have reviewed the statement and/tt~ the be, st of my knowledge the information contained <br /> herein is true and complete. I certify under penalty of perjury under the laws of the State of,Cldifqr'ni~s~flat t~e foregoing is true and correct. <br /> <br /> Executed on , At By " <br /> S~ON*~U~ O~ COmaOtUNO O~F~E.OtOt a. C~NOmATL De St~E MEASUeE eaOeO~EN~ <br /> <br /> Executed on At By <br /> <br /> State Of California Fair PolJtkal P~actices Commission <br /> <br /> <br />