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Home My WebLink AboutForm 410 - Terminationrcz— REGEMW ANU NLCU in the Offift Of the Secretary Of StElft' of the State of ClOnITI0 Statement of Organization Date sump DEC 1.9 2014 Recipient Committee Statement Type ❑ InMal 0 Antendnient rmination —See a Part 5 Not yet qualified ❑ or List I.D. number: /list ITD. number. III Al — /—f—/ Date qualified as commMee Date qualified as committee Date of Termination (dappitab* NAME A ILVAJO 'r FAX /E-MAIL ADDRESS COUNTY Of DOM C ILE ISACTIVE Attach additional information on3appropriately1abeled continuation sheets. NAME Of TREASURER For Official Use STREET ADDRESS (NO P.O &0 NAL1EC;F ASSISTANT TREASURER, iFANY STREET ADDRESS WO P.O. BOX) CITY STATE ZtPCODE AREACODEJPHONE NAME OF FRINC [PAL OFFICER(S STREET ADDRESS (NO P.O. BOX) CITY STATE ZIPCODE AREACODE)PHONE g I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and ccmplet6: [:certify under penalty of perjury under the laws of the State oLCalifornia that the foregoing is true and correct. t Executed on '7 1 /-/ By DATE I OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on BY DATE SIGNATURE OF CO NTROLL MG OFF iCEHOL DER, CANDIDATE, OR STATE MEASURE P ROF014ENT Executed on BY DATE SIGNATURE OFCONTROLUNQ OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 420 (Dec/2012) FPPC Advicei adwke0fppcca.80v (866/27S-3772). wwWJppcca.Baw Ati4ment of Organization ®_ . Recipient Committee All committees must list the financial Institution where the campaign bank account is located. Lily STATE ZIP CODE � � �L 7ey-ese'L !3 /L)J. 91Irn v G4 `?S0Zo . 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 "nonpartisan." e If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY • Primarily formed to support or oppose specific candidates orrmeasures In a single election. List below: CANDIOATE(S) NAME OR MEASUREIS) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATES) OFFICE SOUGHT OR HELD OR MEASUREISOURISDICTION (INCLUDE DISTRICT NO.. CITY OR:COUNTY, AS APPLICABLE) CKCKONE SUPPORT I Oppose FPPC Form 410 (Dec /2012) FPPC Advicee adviee"f c"-9*ov (866 /275 -8772) wwwr fppc cs.gov Nonpartisan Nonpartisan • Primarily formed to support or oppose specific candidates orrmeasures In a single election. List below: CANDIOATE(S) NAME OR MEASUREIS) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATES) OFFICE SOUGHT OR HELD OR MEASUREISOURISDICTION (INCLUDE DISTRICT NO.. CITY OR:COUNTY, AS APPLICABLE) CKCKONE SUPPORT I Oppose FPPC Form 410 (Dec /2012) FPPC Advicee adviee"f c"-9*ov (866 /275 -8772) wwwr fppc cs.gov Statement of Organization Recipient Committee Statement Type ❑ Inroal ❑ Amendment /Li.,t Terminathm —See Part 5 Not yet qua hied ❑ or List I.D. number: I .D. number: „ /3q T325 Date qualified as cormittee Date qualified as committee Date of Termination (M app Kawe) Date Stamp "For [(al Use 1. Committee Information 2. Treasurer and 599i P%indpisl Officers NAME OF COMMi' -EE NAME 0'R AM" loor /Retw 2.o r2- STREET ADDRESS (NO P0. BOXI STREET ADDRESS (NO P NAME OF ASSISTANT TREASURER, IF ANY FAX / E-MAIL ADDRESS STREET ADDRESS (NO P.O. BOX) COUNTY OFDOMICILE IURSDICT ION WHERE COMM RTEE15ACTIVE CITY STATE ZIP CODE AREA CO DE /PHONE NAME OF PRINCIPAL OFFICER(SI Attach additional information on appropriately labeled continuation sheets. STREET ADDRESS (N0 P.O BOX) CITY STATE ZIP CODE AREACODE/PHONE 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 the foregoing is true and correct. Executed 0i — IV on gy DATE r OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on gy DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on Dv DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (Dec /2012) FPPC Advke: sdvke *fppcaca.gov (8"/275 -3772) www.fppc.ca.`ov Statement of Organization CALIFORNIA Recipient Committee FORM 410 INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME L0. NUMBER RAe< Amt., -c--c 13�18 3 2-5 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL I1457 - 'UT"0N AREA CODFIPHONE ADDRESS C,7v aA to e_,re sct. RILA. all, 4. Type of Committee Complete the applicable sections. CR STATE p5o Zo 8 '? 77 2- co ZIP CODE • 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 "nonpartisan." • 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 1 e�1 G�" � vl 1 0. �f' o� �i lY'c� 2,p � Z Nonpartisan ❑ Nonpartisan Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) NAME OR MEASURES) FULLTITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHTOR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE SUPPORT 1 OPPOSE FPPC Form 410 (D*c /2012) FPPC Advice: advice *fppc ca.gov (866/275 -3772) www.fppc.cs.e0v Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE 4. Type of Committee (Continued) PROVIDE BRIEF DESCRIPTION OF ACTIVITY NAME OF SPONSOR STREET Pace 3 -2-0 iz I /-'� el es 3 z- 5. Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ QTY Committee ❑ COUNTY Committee ❑ STATE Committee List additional sponsors on an attachment. N0. AND STREET ❑ -1, Dave qual0ted CITY GROUP OR A FFI IATION Of SPONSOR STATE ZIP CODE 5. Termination Requirements By signingthe verification, the treasurer, assistant treasurer and /or candidate, officeholder, or proponent certify that all of the following conditions have been met: • 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 no intention or ability to discharge all debts, bans 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 Government Code Section 89519. — Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511 - 89518, and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5. FPPC Form 410 (Doe/2012) FPPC Advke: advke *fppe.ea.gav (866/275 -3772) www.fppc.cm.gov COMMITTEE TO ELECT PETER ARELLANO 7100 POTOMAC PLACE GILROY, CA 95020 (408) 842-2974 June 30, 2000 Secretary of State Political Reform Division 1500 11th Street Sacramento, CA 95814 In re: Committee to Elect Peter Arellano Gentlemen: Two numbers were issued in error for the Committee to Elect Peter Arellano. I enclose Form 410 to cancel out #991660, which also has the incorrect spelling of his name. Thank you for your cooperation in this matter. Sincerely, J~r1' {;U-jl~~ June V Otaguro Treasurer Enclosure -- -- z o ~ Z <( ~ a: o LL o f- Z W ~ W ~ r- en s::: o .- - ca .!::! 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