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TERMINATION <br /> Statement of Termination Typ" or Print In Ink, Dalo Slamp <br /> 'Ibis form ntusl he complelcd by officeholders, candidales, anti recipient commiltee~ · <br /> <br /> that wish to terminate pursuant to Govemlnent Code Section 84214. <br /> !~ A For Olficial Uso Only <br /> ? <br /> ~: ,JAN 2 0 1992 <br /> Officeholders and candidates file an original of this form wilh thc filing officer with <br /> whom they file the originals of their campaign slatcmcnu. ~ 0Ir/0F REi~/00D CIPt <br /> Committees file an original of this form with the Secretary of Slate and, if applicable, CIIY CI.£RK <br /> a copy with the local filing officer. <br /> I Officeholder or Candidate Termination I Recipient Committee Termination <br /> NAME OF OFFICEHOLDER OR ~NDID&TI' N~Mi OF COMMITTEEI <br /> ~Lo¢)~.r~T' P,. P) L~ F,. .'-/ '~)~'J C~m'~/~C,:t6 C.c~'<r~m.~TT~_ I''°'"~"''" <br /> RESIDeNtiAL OR BUSINI_SS ADDRESS: {NO AND SIREE'I} ADDRESS OF CO~MIFIEE: ,-~ (NO AND STREET) <br /> <br /> Af~ ~ ~ NUIdB£R . AREA, CODE/P!IONE NU~ER <br /> <br /> OFFIC& fOUGHT OR HELD~ NAME OF TaEJ, IUREIIb <br /> 'x./~ r~ ¢ - ¥ ~ i~ ¥c ~ (-6 ~ c~ ~ ct t.~ ,0,,0~ 'C~f:O'~ ~ r,~ c, ~ r': ~ Y. <br /> <br /> ,~rFECll'~ DAlE OF TERMIN~TII~Ic ZiP <br /> <br /> III Verification III Verilicalion <br /> I have u~ed all reasonable diligence in preparing this $1alemenl, l have ceased to receive I have used all reasonable diligence in prepa~ing this slalement. This commillee has ceased Io <br />· a conL, ibutions and make expenditures; do not anticipate receiving contributions or repayments of receive conuibutions and make expenditures; does not anticipate receiving conuibhtions or <br /> outstanding loans made to others or any other receilas, or making expenditures in the future; repayments of outstanding loans made to others or any other receipts, or making expenditures in <br /> have eliminated or declare that I have no intention or ability to discharge all debts, loans the future; has eliminated or declares that it has no intention or ability to discharge all debts. <br /> received, and other obligations; have no surplus beds; and have filed all campaign statements loans received, and other obligations; has no surplus funds; and has filed all campaign state- <br /> required by die Political Reform Act disclosing all reportable I~ransacdons. merits required by Ihe Political Reform Act disclosing all reportable transactions. <br /> I c~tify under penalty of perjury under thc laws of the State of California that the foregoing is I certify under penalty of perjury under the laws of the State of California that die foregoing is <br /> Irue and correct. Irue and correct. <br /> ~ E~omod~ I'" ~O" q :;2-- ^:'~.?U:h.~n~) c~-r"J---C/-v. Exac.:a~on I"- <br /> , -- ;, <br /> [ Executed on Al ' <br /> <br /> By <br /> <br /> Exoculod on Al <br /> <br /> By <br /> <br /> NOTE: ^ddifional filing obligations will be incurred il an officeholder, candidate, or commil~ee Executed on At <br /> begins raising or spending funds or receives the for§iveness of a loan or repaymenls of . <br /> loans made Io others or any other roceipls. By <br /> <br /> FOIl II'FORMATION REQUIRED TO BE PROVIDED TO YOU PURSUANT TO THE IHFOnMATIOI~I PRACTICES ACT OF 1977. ,SEE INFORI%~'I'ION MAFIU^L ON CAMPAIGN DISCLOSUFIIE PROVISIONS OF THE POU_~. <br /> <br /> Sial® of Calllornl., F&lr Pollllcal Practlc®~ CommlsDIon. <br /> <br /> <br />