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Form 410 Termination
Statement of Organization CITY «I, Recipient Committee DNe a Statement TYPa p Initial Amendment © TermlMtlon•ass PAM1 a i[,i 13 �_� !`G 1'1.1 c?: For OlM1de flee Only Not yd quaffed ❑ or 1389864 09113/2016 11/23/2016 Daft qudMad as ceremMSe Dale qualified as mrrAftee Dale d TwMnoon PaEaamn 1. Constra Al ariftery apOn __ - .. .. �2; Tydpwtex glad cthx Mmilpal Oliloprs COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Tony Brandenburg for Encinitas City Council 2016 Kevin K Forrester STREETADDRESS(NO P.O.BOX) STATE ZIP CODE AREA CODE/PHONE Encinitas,CA 92024 7609441918 Encinitas CA 92024 7609441918 MAILING ADDRESS(IF DIFFERENT) NAME OF ASSISTANT TREASURER,IF ANY FAX I EMAIL ADDRESS STREET ADDRESS(NO P.O.BOX) /kforresteriMDSmlexs COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE CITY STATE ZIP CODE AREA CODEIPHONE San Diego City of Encinitas NAME OF PRINCIPAL OFFICER(S) Anthony J.Brandenburg STREET ADDRESS(NO P.O.BOX) Attach additional information on appropriately laded continuation sheets. 648 Lomas de Oro Ct CITY STATE ZIP CODE AREA CODEIPHONE Encinitas CA 92024-6528 7805254569 I have used all renonsEle diligence In preparing and reviewing Ms satamerd and W the bM of"knowledge the idomWm ne Mre and In are resch W scladufea Is true and canolde.I nNfv under oanNN of nedury under the laws of the Ste&of Cdearda Vat the foread a is tnd end rrad. Evededon /7- L3—qy/L a, mw r Easueed an ll '2 30 1G so• n MTnauw ow etPUeaa ,e..mes.eau MSUUM Aasarom sa.aesMS anvwmeaawr or Executed an av pee eaamM m aaMamo ataMaeae.cseuw.sws a .PMaem1 Fmea on or M eaumnmcaraMae aayIMOX.CeNWM.9ew Meeue PMpo-MM FPPC Fore da(Dee12012) FPPC Advice:adrlee®lppesagov ISW276J772