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410 Pearce CC W7 (03-07-19)_R
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5/22/2019 3:15:36 PM
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City Clerk
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Agendas
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Statement of Organization <br />Recipient Committee <br />INSTRUCTIONS ON REVERSE <br />COMMITTEE NAME <br />D r. t,.) t ((l �, f� e�, we,r-d_ ? 2 0 ( t <br />4. Type of Committee <br />(Continued) <br />General Purpose Committee <br />Not formed to support or oppose specific candidates or measures in a single election. Check only one box: <br />0 CITY Committee 0 COUNTY Committee ❑ STATE Committee <br />PROVIDE BRIEF DESCRIPTION OF ACTIVITY <br />Sponsored Committee <br />List additional sponsors on an attachment. <br />NAME OF SPONSOR <br />INDUSTRY GROUP OR AFFILIATION OF SPONSOR <br />STREET ADDRESS <br />NO. AND STREET <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />Small Contributor Committee' <br />❑ / / <br />Date qualified <br />5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that all of the following conditions have been met: <br />• This committee has ceased to receive contributions and make expenditures; <br />• This committee does not anticipate receiving contributions or making expenditures in the future; <br />• This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; <br />• This committee has no surplus funds; and <br />• This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. <br />-- 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 <br />Code Section 89519. <br />-- Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511- 89518, and are <br />subject to Elections Code Section 18680 and FPPC Regulation 18521.5. <br />FPPC Form 410 (August/2018) <br />CDDf Ads/ire, arluironfnnr ra onu IRF:F:/775-37771 <br />
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