Form 410 termination Statement of Organization
Recipient Committee
Statement Type
❑Initial
Not yet qualified ❑ or
t 3 L_4 5
Date qualified as committee
Type or print in Ink
❑ Amendment
List I.D.number:
#
Date qualified as committee
(it SPOWWO)
Termination—See Part S
List I.D.number:
# 13061-q5
/4 1 .2,Al
Date of Twrninatlon
CITY
CITY CLEF?M"
10 f 3 JAN -8 AM 11: 5
1 Committee information 2. Treasurer and Other Principal Officers
.
NAME OF COMMITTEE
iE�D� nF �� NECGE (:GLL1�2
STATEMENT OF ORGANIZATION
CODE AREtCIOD�P )NE
NAME OF I TANT TREASURER,IF ANY
STREET
yyCODEIP ONE
OPTIONAL• FAXlE-MMLADDRESS � /,/a,/jd ("���l. (I / '�go�� 63 �18
NAME AND POSITION F OTHER PRINCIPAL OFFICER(8),IFAPPLICABLE
COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE MAILING ADDRESS
SAS _� e J
CITY STATE ZIP CODE AREA CODE/PHONE
Attach addfNonal hfonnation on appropriately labeled continuation sheets.
3. Verification
I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein Is true and complete. I certify under penalty of
perjury under the laws f the St e of California that the foregoing Is true and cor
Executed on i l Q 5 //`�- ey
TREASr R O
� 7 lam- B `
EKStCU�d On DATE y SIGNATURE EHOLDER,CANDIOA STATE MEASURE PROPONENT
Execuled On DATE
Executed an
DATE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE.ORS ATE MEASURE PROPONENT
FPPC Form 410(JanuarylOS)
FPPC Toll-Free Helpiine:8661A3K-FPPC(8661275-3772)
Statement of Organization
Recipient Committee
IN8TRUCTIONS ON REVERSE
HeL,L E (T01,.Ll E 4
4.Type of Committee Complete the applicable sections.
Pape 2
�ZA
• List the name of each controlling officeholder,candidate,or state measure proponent. If candidate or officeholder controlled,also list the elective office sought or held, and
district number, if any,and the year of the election.
• List the political party with which each officeholder or candidate is affiliated or check"non-partisan"
• If this committee acts jointly with another controlled committee,list the name and Identification number of the other controlled committee.
ELECTIVE OFFICE SOUGHT OR HELD
NAME OF CANDIDATElOFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
• List the financial Institution where the campaign bank account is located(controlled"candidate election"committees only)
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
✓-- 6 To,v v�- v �1 `a.— ! 13 L+ -5
ADDRESS CITY STATE ZIP CODE
aA
Primarily Ibmwd to support or oppose specific candidates or measures in a single election. List below.
CANDIDATE(S)NAME OR MEASURE(S)FULL TITLE(INCLUDE BALLOT NO.OR LETTER) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURES)JURISDICTION
(INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE)
FPPC Form 410(January/05)
FPPC Toll-Free Helpllne:866 1ASK-FPPC(6661275-3772)
E/C�
5 Non-Partisan
❑ Non-Partisan
• List the financial Institution where the campaign bank account is located(controlled"candidate election"committees only)
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
✓-- 6 To,v v�- v �1 `a.— ! 13 L+ -5
ADDRESS CITY STATE ZIP CODE
aA
Primarily Ibmwd to support or oppose specific candidates or measures in a single election. List below.
CANDIDATE(S)NAME OR MEASURE(S)FULL TITLE(INCLUDE BALLOT NO.OR LETTER) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURES)JURISDICTION
(INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE)
FPPC Form 410(January/05)
FPPC Toll-Free Helpllne:866 1ASK-FPPC(6661275-3772)