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Form 410 Termination 1/3/01 Statement of Organization Recipient Committee STATEMENT OF ORGANIZATION Type or print In Ink Date Stamp CALIFORNIA 41 0 FORM For O1IIcfal Use Only Statement Type 0 Initial Not yet qualified 0 or 0 Amendment LIst J.D. number. IX] Termination - See Part 5 LIst J.D. number. # # 961390 I 1 Date qualified as committee I I, Date qualified as committee (If applicable) 1.LJ 3 1 I..Q..Q Date of Termination 1. Committee Information NAME OF COMMITTEE 2. Treasurer and Other Principal Officers NAME OF TREASURER John C. Lechleiter MAILING ADDRESS ~ Friends of Chuck DuVivier STREET ADDRESS (NO P.O. BOX) 144 West D street CITY pTATE ZIP CODE AREA CODE/PHONE 1182 Rancho Encinitas Drive CITY STATE ZIP CODE AREA CODE/PHONE Encinitas, CA 92024 (760)753-1157 NAME OF ASSISTANT TREASURER, IF ANY N!A MAILING ADDRESS Encinitas, CA 92024 MAILING ADDRESS (IF DIFFERENT) (I9~ 942-8647 CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX I E-MAIL ADDRESS NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY Of DOMICILE MAILING ADDRESS San Diego CITY STATE ZIP CODE AREA CODE/PHONE . Attach additional information 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 of the State of Califomia that the foregoing is true and correct. Executed on 1/3/2001 . DATE !)r . :..)0 I DATE By Executed on By Executed on DATE By SIGNATURE OF CONTROLLING OFACEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By SIGNATURE OF CONTROlLING OFFICEHOLDER, CANDIDATE. OR STATE Ml:ASlJR~-PÆOPON~Nr DATE FPPC Form 410 (8199) For Technical Assistance: 916/322-5660 -' Statement of Organization Recipient Committee STATEMENT OF ORGANIZATION INSTRUCTIONS ON REVERSE CALIFORNIA 41 0 FORM p. 8. a. e. 2 9 I.D. NUMBER COMMITTEE NAME Friends of Chuck DuVivier 961390 4. Type of Committee Complete the applicable sections. Controlled Committee . 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. 8 NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARlY IK] Non-Partisan Charles G. DuVivier Encinitas Couhcil Member 1996 0 Non-Partisan . List the financial institution and the disposition of surplus funds (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION AREA CODEIPHONE BANK ACCOUNT NUMBER DATE OPENED San Diequito National Bank ADDRESS' CllY (760)436-5226 STATE ZIP CODE 01-253-034 DISPOSITION OF SURPLUS FUNDS There wérenosurplus funds. 8/12/92 8 135 Saxony Rd., Encinitas, CA 92024 Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION CANDIDAT"') NAME aR MEASUR,,') FULL TIm (INCLueE BALLaT Na, aR LETTER) I ('NCLueE D'STR'CT NO.. Cm' OR COUNTY. AS APPLICABLE) I su,,<:;::'CKI~;"'" SUPPORT OPPOSE FPPC Form 410 (8/99) For Technical Assistance: 916/322-5660 Statement of Organization Recipient Committee STATEMENT OF ORGANIZATION INSTRUCTIONS ON REVERSE CALIFORNIA 41 0 FORM P' I. att, 3 ge I.D. NUMBER COMMITTEE NAME Friends of Chuck DuVivier 961390 4. Type of Committee (Continued) General Purpose Committee Not formed to support or oppose specific candidates or measures In a single election. Check only one box: 0 CITY Committee 0 COUNTY Committee 0 STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY 8 Sponsored Committee List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR MAILING ADDRESS NO. AND STREET CITY STATE ZIP CODE Broad Based Committee 0 (For purposes of special election contribution limits) 5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that all of the following conditions have been met: 8 . 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 nD 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 the Information Manual on Camoaign Disclosure Provisions of the Political Reform Act. for Elected Officers. Candidates and their Controlled Committees (Manual A). -- Additional filing obligations will be incurred if, after terminating, the committee receives or spends any funds, or receives the forgiveness of a loan, repayments of loans made to others, or any other receipts. FPPC Form 410 (8199) For Technical Assistance: 9161322-5660