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RECIPIENT COMMITTEE <br />Recipient Committee WHERE TO FILE: STATEMENT OF TERMINATION <br />Statement of Termination SecretaryFile°riginaland°nec°py°fthisf°rmwith:of State ~: !!.:~ {:~ ~:~I'h~ ~ <br />This form must be completed by recipient committees Political Reform Division <br />that are eligible to terminate pursuant to Government P.O. Box 1467 ~;, For Official Use Only <br />Code Section 84214. Sacramento, CA95812-1467 FE~ 1 7 1999 <br /> Type or print in ink. And, if applicable, file one copy <br /> The city or county officer, if any, C;¥Y C,:=: ~,~ L/:3(7 r) G~TY <br /> comm~ee's campaign disclosure statements. ~'~,,, <br /> <br />I Recipient Committee Information II Treasurerlnformation <br /> NAME OF COMMITTEE I.D. NUMBER NAME OF TREASURER <br /> <br /> '~,~ C ; ~.-c, C ~'~ C ; ,/ MAILINGADDRESSOFT~ASURER NO. ANDSTREET <br /> ADDRESS OF COMMITTEE / NO. AND STREET /~ ~'~, <br /> <br /> (~ ~' III Effective Date of mermination [~o i'~~ ~ ~-/ <br /> <br /> A. This committee has ceased to receive contributions and make expenditures; <br /> <br /> C lhi~ ~ommitt~ h~ ~liminat~d or d~l~r~ that it ha~ no intention or ability to di~rhar~ ,Il d~bt~, Io~n~ r~i~d, and, <br /> <br /> D. This committee has no surplus funds; and <br /> <br /> E. This committee has filed all campaign statements required by the Political Reform Act disclosing all repo~able transa( <br /> <br /> I have used all reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my kno~ <br /> herein is true and complete. I ce~ify under penalty of perjury under the laws of the State of California that the foregoing ,~ <br /> <br /> Executed on D At OTY AND ~E ~ / <br /> h /~ SIGNORE O~TREASURER <br /> / DATE CITY AND STATE/ / ~ SIGNATURE OF CONTROLLING OFFICEHOLDER, ~NDIDATE OR STATE MEASURE PROPONENT <br /> Executed on L At By <br /> DATE CITY AND STATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT <br /> <br /> Executed on At By. <br /> DATE CITY AND STATE SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE, OR STATE MEASURE PROPON[N1 <br /> <br />FOR INFORMATION REQUIRED TO BE PROVIDED TO YOU PURSUANT TO THE INFORMATION P~CTICE5 ACT OF 1977, SEE INFORMATION MANUAL ON CAMPAIGN DISCLOSURE PROVISIONS OF THE POLITICAL REFORM AO. <br /> <br /> State of California Fair Political Practices Commission <br /> <br /> <br />