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HomeMy WebLinkAboutCarlyn Christianson - Form 410 - Termination Statement - 08-27-2013Statement of Organization Recipient Committee Statement Type ❑ Initial Not yet qualified ❑ or 03 /12 12013 Date qualified as committee ❑ Amendment List I.D. number: #1355988 Date qualified as committee (If appIIca ble) 1. Committee Information NAME OF COMMITTEE Carlyn Christianson for City Council 2013 STREET ADDRESS (NO RO. BOX) ® Termination — See Part S List I.D. number: # 06 /30 /2013 Date of Termination CITY STATE ZIP CODE AREA CODE /PHONE San Luis Obispo Ca 93401 ( MAILING ADDRESS (IF DIFFERENT) FAX / E -MAIL ADDRESS carlynpc @gmail.com COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE San Luis Obispo City of San Luis Obispo Attach additional information on appropriately labeled continuation sheets. Date Stamp For Official Use Only LRECEIVED I K 2. Treasurer and Other Principal Officers NAME OF TREASURER Jeri F. Carroll STREET ADDRESS (NO P.O. BOX) CITY San Luis Obispo STATE CA ZIP CODE 93401 AREA CODE /PHONE ( NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO RO. BOX) CITY STATE ZIP CODE AREA CODE /PHONE NAME OF PRINCIPAL OFFICER(S) STREET ADDRESS (NO P.O, BOX) 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 perjury under the laws of the State of California that ore ( AATF R S1GNArUIR 11AiT: SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on DATE Executed on DATE By OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT By 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