410 Jalani Bakari Darryl Martin W3 (07-05-19) Termination_R

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Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME Jalani Bakari For riverside City council Ward 3 2019 General Purpose Committee an inued cNr t, i dirk Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ® CITY Committee 0 COUNTY Committee 0 STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY Sponsored Committee List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE Small Contributor Committee / / Date qualified � es Weraf�ca -.the tr a t r r f r 1 F 1 L asurer assistant treasurer:and —"r- • •ndidate officeholder, w k r ro nicer P OWE t ori':". .on ng e d;Fti ..Vr 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, Loans 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 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov