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Form 410 Termination Statement of Organization 1 T Y �Stamp C IP31 T t1`. • - ' Recipient Committee - _ Statement Type [ _initial ❑ Amendment ❑ Termination—see Part 5 For Official Use Only Not yet qualified[I or List I.D.number- List I.D.number: JUL 2 3 ; Z # # 1 371 353 PY7 09/09/2014 co t t __/ .1 6 / 30—/ 2015 Date qualified as committee Date qualified as committee Date of Termination (If applicable) NAME OF COMMITTEE NAME OF TREASURER Alan Lerchbacker for City Council 2014 Nancy Haley CITY STATE ZIP CODE AREACODE/PHONE CITY STATE ZIP CODE AREACODE/PHONE Encinitas, CA 92024 626-644-6452 Encinitas, CA 92024 760-632-3600 MAILING ADDRESS(IF DIFFERENT) NAME OF ASSISTANT TREASURER,IF ANY Stephanie Sanchez FAX/E-MAIL ADDRESS STATE ZIP CODE AREA CODE/PHONE San Diego Encinitas, CA 92024 760-632-3600 NAME OF PRINCIPAL OFFICER(S) Attach additional information on appropriately labeled continuation sheets. STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE I have used all reasonable diligence in pr aring t s t ement and to the b st yf k n ledge the information contained herein is true and complete. I certify under penalty of perjury under the laws of the S to of o i t a f r l n o ect. Executed on O By D A R ASSISTANT TREASURER Executed on By DATE cl" OLLING OFFICEHOLD%LANDIDATE,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) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov Statement of Organization CALIFORNIA ' Recipient Committee FORM INSTRUCTIONS ON REVERSE 2 of 3 COMMITTEE NAME I.D.NUMBER Alan Lerchbacker for City Council 2014 1371353 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREACODE/PHONE BANK ACCOUNT NUMBER Torrey Pines Bank 760-444-8400 4110751748 ADDRESS CITY STATE ZIP CODE 2760 Gateway Road Carlsbad CA 92009 • 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"nonpartisan." • 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 CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY City of Encinitas Nonpartisan Alan Lerchbacker City Council Member 2014 ❑ Nonpartisan Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below- CANDIDATE(S)NAME OR MEASURE(S)FULL TITLE(INCLUDE BALLOT N0.OR LETTER) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(5)JURISDICTION (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 410(Dec/2012) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov Statement of Organization CALIFORNIA ' Recipient Committee FORM INSTRUCTIONS ON REVERSE 3 of 3 COMMITTEE NAME I.D.NUMBER Alan Lerchbacker for City Council 2014 1371353 General •• Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee ❑ COUNTY Committee❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY •• List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO.ANDSTREET CITY STATE ZIP CODE Small Contributor Committee Date qualified • This committee has ceased to receive contributions and make expenditures; • This committee does not anticipate receiving contributions or making expenditures in the future; • This committee has eliminated or has no intention or ability to discharge all debts,loans received,and other obligations; • This committee has no surplus funds;and • This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. -- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government Code Section 89519. -- Leftover funds of ballot measure committees maybe used for political,legislative or governmental purposes under Government Code Sections 89511-89518,and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5 FPPC Form 410(Dec/2012) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov