HomeMy WebLinkAboutJohn Spatafore - Form 410 - Termination Statement - 06-06-2013Statement of Organization
Recipient Committee
Statement Type ❑ Initial
Not yet qualified ❑ or
I r
Date qualified as committee
Type or print in ink
❑ Amendment
List I.D. number:
Date qualified as committee
(If applicable)
/Termination — See Part 5
List I.D. number:
# /36-7//7
oi D (. 1 7-40 13
Date of Termination
1. Committee Information
NAME OF COMMITTEE
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2
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13
STREETADD (NO P.O. BOX)
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CITY STATE
ZIP CODE
AREA CODE /PHONE
90
MAILING ADDRESS (IF DIFFERENT)
OPTIONAL: FAX/ E -MAIL ADDRESS
COUNTY OF DOMICILE
COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
/ n
THAN COUNTY OF DOMICILE
Attach additional information on appropriately labeled continuation sheets
STATEMENT OF ORGANIZATION
Date
For Official Use Only
JUN 0 6 2013
2. Treasurer and Other Principal Officers
NAME OF TREASURE
lCp3�-
STREET ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
L, yr s O %/ s n0 C--- 93 Y 9
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
NAMEAND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE /PHONE
3. Verification
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 the foregoing is true and correct—
Executed on By
DATE OFTREASURER OR ASSISTANT TREASURER
Executed on 3 By
LATL 1101-1 SIGNWP4 OF CXNTROLUNG OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
Executed on
DATE
DATE
By
By
SIGNATURE
SIGNATURE
OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
OFFICEHOLDER, CANDIDATE, Of: STATE MEASURE PROPONENT
FPPC Form 410 (January/05)
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