HomeMy WebLinkAboutMERRILL 410 TERM 10/21/16Statement of Organization De" MOT,
-Ife—cipient Committee
Statement Type ❑Initial ❑Amendment Ild Termination -See Parts RE EIVED AND
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Attach additional information on appropriately labeled continuation sheets.
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NAME OF TREASURER
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NAME OF ASSISTANT TREASURER, IF ANY
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FPP[ Form 010 (lax /2016)
FPP[ Advice: advice@afppc.ca.gov (865/275-3772)
wvrw.fPpc.w.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
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• All committees must list the financial insdtudon where the campaign bank account is looted.
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• 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 DFCANDIDATE/ OFFICEHOLDER /STATE MEASURE PROPONENT INCLUCE DISTRICT NUMBER IF APPLI CABLE) YEAR OF ELECTION PARTY
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Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATES) NAME OR MEASURES) FULL TITLE (INCLUDE BALLOT NO, OR LETTERI CANDIDATES) OFFICE SOUGHT OR HELD OR MENSUREF S) JURISDICTION
PPP[ form 410 (lan /2016)
FPPC Advice: advice @fppc.w.gov (866/275 -3772)
www.fppc.ca.gov
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PPP[ form 410 (lan /2016)
FPPC Advice: advice @fppc.w.gov (866/275 -3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
M ERRit Foe MAyorz .2016 l 383NS9
Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee
List additional sponsors on an attachment.
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S. Termination Requirements By sip: MgthsverllkatRN, eheveaswer, aslstanirrnwrca nArmwMldate,oM.lx:I.,orMm rtaNfyt hrtallofthe iolbwingmMmom have beenrnet:
• 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 5ection 18680 and FPPC Regulation 18521.5.
FPPC Form 410 (Jan /2016)
FPPC Advice: advlcevfppc.ca.gov (866/275 -3772)
www.fppc.a.gov