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410 Avery CC W3 (03-18-19)_R
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Statement of Organization <br />Recipient Committee <br />INSTRUCTIONS ON REVERSE <br />COMMITTEE NAME <br />Warren Avery for Riverside Ctiy Council Ward 3 2019 <br />4. Type of Commi <br />General Purpose Committee!' <br />>ontinue <br />Not formed to support or oppose specific candidates or measures in a single election. Check only one box: <br />® CITY Committee 0 COUNTY Committee 0 STATE Committee <br />PROVIDE BRIEF DESCRIPTION OF ACTIVITY <br />11 Sponsored Comtnideellot <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 />({' rripll <br />Contributor Comii ltteei lei <br />0 / / <br />Date qualified <br />5 Termination Requirernen <br />e ve <br />ificatton the treasurer assistant treasurer and/or candidate officeholder <br />that all <br />ofthefollowi i <br />nditions,})ave,b <br />nme! <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 />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />
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