HomeMy WebLinkAboutForm 410_SLO Citizens for Measure G_2021-12-27_TerminationSAN LUIS OBISPO
COUNTY OF DOMICII.E
lnitial
Not yet qualified
or
Date qualification threshold met
//
E Amendment
Date qualification threshold met
/ l_
Attoch odditionol informotion on appropriotely lobeled continuotion sheets.
JURISDICTION WHERE COMMITTEE IS ACTIVE
SAN LUIS OBISPO
E.MAIL ADDRESS (REQUIRED} / FAX (OPTIONAL)
HGTROUT@GMAIL.COM
P.O. BOX 15139, SAN LUIS OBISPO,CA93406
FULL MATLING ADORESS (IF DIFFER€NI)
AREA CODE/PHONE
805-709-5194SAN LUIS OBISPO
z[' coDECITYSTATE
cA 93401
II73 BUCHON STREET
STREET ADDRESS (No Po. Box)
SLO CITIZENS FORYES ON MEASURE G
NAME OF COMMITTEE
f.D. Number vzzgtg
Date of termination
12 ,27 ,2021
-l -I
Z Termination - See Part 5
Date Stamp
DEc 3 o 2tj21
;rl\-; r-JLuecieiary cf
of Ce lilornia
tiie
of the
oliice of
State
!-)
CITY ZIP CODE AREA CODE/PHONESTATE
STREET ADDRESS (NO P.O. BOX)
NAME OF PRINCIPAL OFFICER(5)
CITY 2IP CODE AREA COOE/PHONESTATE
STREET ADDRESS (NO P,O. BOX)
NAME OF ASSISTANT TREASURER, IF ANY
AREA CODE/PHONE
805-709-5194SAN LUIS OBISPO
ZIP CODECITYSTATE
cA 9340t
1173 BUCHON STREET
STREEI ADDRESS (NO EO. BOX)
NAME OF TREASURER
HILLARYTROUT
JAN o 3 2022
For Official Use Only
cALTFoRNIA 410
1. Committee lnformation 2. Treasurer and Other ncipalOfficers
3. Verification
Statement of Organization
Recipient Committee
Statement Type
reaS0na prepanng is statement to my
penalty of perjury under the laws of the State of that regoing is true and correct.
121271202tFxecuted on
n an comp
Executed on
Executed on
DATE
DATE
OATE
By
By
By
By
SIGNATURE OF TREASURER OR ASSISTANT TREASURER
sIGNATUR€ OF CONTROTTING OFFICEHOLDER, CANDIDATE, OR 5TATE MEASURE PROPONENT
SIGNATURE OF CONTROTIING OFFICEHOI-DER, CANDIOATE, OR STATE MEAsURE PROPONENT
RECHIVED
JUN 2 I ?023
SLO CIW ELERK
FPPC Form 410 (August/20181
FPPC Advice: advice@fppc.ca.qov 18661275-377 2l
www.fpoc.ca.gov
Executed on
DATE SIGNATURE OF CONTROI-LING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT