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HomeMy WebLinkAboutDan Carpenter - Form 410 - Termination - 12-15-2008Statement of Organization Recipient Committee Type or print in ink Statement Type ❑ Initial - ❑ Amendment Not yet qualified ❑ or List I.D. number: Date qualified as committee Date qualified as committee (If applicable) XTermination — See Part 5 °n t List I.D. number: # f j ©6S2c� Date of Termination '.#"EIVED AND FIL, office of the Secretary of of the State of California DEC 17 2008 )EERA BOWEN ecratary of Stag 1. Committee Information -y 2. Treasurer and Other Principal Officers NAME OF COMMITTEE NAME gF_TREASURER �G'f �h. � ett+e_r Ct''y C94%&6 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE c4.. L.LL,s Qb,tea, e-F 93yo/ c i5Y3 -621/ MAILING ADDRESS (IF OPTION L: FAX/ E -MAIL ADDRESS �5caf d Q C.V��r• he�_ COUNTY OF DOMICILE COUNTY WHERE COMMITTEI THAN COUNTY OF DOMICILE .. Lu.s ) loI s 0 Attach additional information on appropriately labeled continualion sheets. STREET ADDRESS STATEMENT OF ORGANIZATION rory Uair:+ -WLin .�F L ,ii OED, 2 9 1908 SLO CITY CLE STATE Zip CODE AREA CODE/P tj-� gFYv i s yVe 9 STREET ADDRESS � to U ub ewe, (fA- 913 Son r W 'ITION OF OTHER FftNCIPAL OFFICER(S), IFAPPLICASLE MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE 3. Verification I have used all reasonable diligence in preparing this statement and to the best of my knowledge the info n 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 cor Executed on J0 ,QG • /�` Z 009 By DATE TREASURER OR ASSISTANT TREASURER Executed on C ._ / * By DATE n for nF P2nKA9TRi 7 Hwr rwpir wnl nFQ remn7nA m nR CTATF urA_%LIRF PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE, ORSTATE MEASURE PROPONENT Executed on By RC C E I V E DE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT IY FPPC Form 410 (January/05) Q�( 2008 FPPC Toll -Free Helpline: 866 /ASK -FPPC /' '75.3772) lCITY f3 Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 2 c,vmn +, wr.G v ee 4o C9,-/ C I /;,?()b5Zc 4. Type of Committee Complete the applicable sections. • 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. ELECTIVE OFFICE SOUGHT OR HELD NAME OF CANDIDATE /OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY Non- i�artlsaR rl Non - Partisan • List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION AREA CODEIPHONE BANK ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE SDK Ga.s 06rxm c04 �.3 yo/ Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) ON OPPOSE FPPC Form 410 (January/05) FPPC Toll -Free Helplin(D: 866/ASK- FPPC"^ V2753772) Staferr, of Organization Recipient Committee Statement Type ❑ Initial Not yet qualified ❑ or _ —I 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. Date of Termination 1. Committee Information _ - 2. Treasurer and NAME OF COMMITTEE NAME QETRFASURFR .uv f ett-fe or ci�y C49 4 %kc'i STREET ADDRESS (NO P.O. BOX) . CITY STATE ZIP CODE AREA CODE/PHONE La's Qb '.4v©, GF 93vo/ sy3 -s2ii MAILING ADDRESS (IF DIFFERENT) UVIIV15ca,,l,JP L: I'- MAILADDKE55 Q CC,&.v4e_► f'1e ' COUNTY OF DOMICILE -ScLv, , L o,s ®lo= ADDRESS Date Stamp RECEIVED _0 CITY CLERK Principal Officers STATEMENT OF ORS kTION For Official Use Only GI rr ■ STATE ZIP CODE AREA CODEfPHONE , C y 1v1 t S� y _;fe - w Lu tw NAME AND POSITION OF OTHER COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE MAILING ADDRESS Attach additional information on appropriately labeled continuation sheets. CA_ 913Sin� IF APPLICABLE CITY STATE ZIP CODE AREA CODEIPHONE 3. Verification 1 have used all reasonable diligence in preparing this statement and to the best of my knowledge the info ' n 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 car Executed on Dec. f� 7-00,0 By ORASSfSTANT TREASURER - — Executed on L��eC'�` Z� By RAT. �:- -- - - -- ----- "----- - - - - -- Executed on DATE Executed on DATE By By SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE, OR STATE MFASIJRE PROPONENT FPPC Form 410 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC V 5 -3772) Stateri.Cnt of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME T.D. NUMBER - t', Ca v De In-f e 40 ✓ C y coo t^ C. '/ •?© b 5Zo 4. Type of Committee Complete the applicable sections. • 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. ELECTIVE OFFICE SOUGHT OR HELD NAME OF CANDIDATE /OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY Da-Non t, ( - YN+� C C®.�V, cs Il yo08' - Parsan ti [� Non - Partisan • List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION AREA CODEfPHONE BANK ACCOUNT NUMBER coast 9CLnk_ a o!�'_ Sy /- O X00 / ADDRESS CITY STATE ZIP CODE Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATES) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECKONE SUPPORT OpPL3SB FPPC Form 410 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC 1""512753772)