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HomeMy WebLinkAbout2022.12.30_Landrum_Form 410 (Termination)Statement of Organization Date Stamp , • Recipient Committee CityRECEIVE of Bay • ' I t 11111 Statement Type El Initial ❑ Amendment Termination — See Part 5 For Official Use Only Q Not yet qualified DEC 3 Q 2022 or Q Date qualification threshold met Date qualification threshold met Date of termination City Clerk !z / 2 1. Committee Information I.D. Number�J 3� p IicableJ and Other PrincipalOfficers (ija NAME OF COMMITTEE NAME OF TREASURER �'P�&AL7P—UN\ %02 Gl`%-( G'Dv'QGl L ®R lG STREET ADDRESS (NO P.O. BOX) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Molz2C� t310111 cA 'Z - , CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY NioP-eC) GA CA . 2 FULL MAILING ADDRESS (IF DIFFERENT) STREET ADDRESS (NO P.O. BOX) E-MAIL ADDRESS(REQUIR(EDD)/ FAX (OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S) s,�� Is d3ts�c� c t ©� MoRRo ItJ I. At.S�� m STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Attach additional information on appropriately labeled continuation sheets. 3. Verification N1�22a `� GA q 3+ -R- 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 on / Z -2— Z ' 2- By DIE SIGNA-TM OF CONTROLLING OFFICEHOLDER, CANDIDATE, URE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (August/2018) FPPC Advice: advice0fnpc.ca.gov (866/275-3772) www.fppc.ca.gov