Form 410 Termination Statement of Organization j Date Stamp CALIFORNIA
Recipient Committee 1",
4107
. r O E G'I`
Statement Type V i
❑Initial ® Amendment m Termination—See Part 5 I''I ( t ' '` for Official Use Only
Not yet qualified ❑ or List I.D.number- List I.D.number t D, —2 1L I ��� 3 ,
# 1367502 # 1367502 ` ��'
06 /9 2014 10 23 /2014 12 /2014
Date qualified as committee Date qualified as committee Date of Termination
(If applicable)
1. Committee Information 2. Treasurer and Other Principal Officers
NAME OF COMMITTEE NAME OF TREASURER
Graboi for Council 2014 Julie Graboi
STREET ADDRESS(NO P.O.BOX) STREET ADDRESS(NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE
Encinitas, CA 92024 (760)436-7818 Encinitas, CA 92024 (760)436-7818
MAILING ADDRESS(IF DIFFERENT) NAME OF ASSISTANT TREASURER,IF ANY
N/A
FAX/E-MAIL ADDRESS STREET ADDRESS IND P.O.BOX)
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE CITY STATE ZIP CODE AREA CODE/PHONE
San Diego Encinitas
NAME OF PRINCIPAL OFFICER(S)
Julie Graboi
STREET ADDRESS(NO P.O,BOX)
Attach additional information on appropriately labeled continuation sheets. Encinitas, CA 92024
CITY STATE ZIP CODE AREA CODE/PHONE
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 perjur under the laws of the State of C 'fornia t� he foregoing is true and correct.
X"?'
Executed on I 201 gy
Executed on Z/
DA / SIGNATURE OF TREASURER OR ASSISTANT TREASURER
y L g f//�f/'lam r
ATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
FPPC Form 410(Dec/2012)
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www.fppc.ca.gov