HomeMy WebLinkAboutSMITH PATRICIA 416 fficeholder and Candidate
Statement of Termination
This form must be completed by officeholders and
cand~dat,, ttet me elig;bte to ttq,winate pursuant
to Government Code Section 84214.
OffiehoMer pr Candidate Termination
NAME OF OFFICEHOLDER OR rANDIDA TE
crrY
AREA CODE/DAYTIME PHONE NUMBER
NO. AND STREET
STATE ZIP CODE
OFFICEHOLDER AND CANDIDATE
STATEMENT OF TERMINATION
Date Stamp
Officeholders and candidates must file ' ~) JUL 23 PH 12:25
Form 416 with the filing officer with
whom they filed their original campai~ C IT Y CL E
statements (Form 470 or 490). RSFIELD.
II Office Sought or Held
JURISDICTION (iF ANq, ICABLE) (Lfl DISTRICT NUMBER (IF APPLICABLE)
III Effective Date of Termination
DATE FILING OBLIGATIONS WERE COMPLETED
IV Verification
For the office listed in Part !t of this form, I verify that:
A, do not hold or am no longer a candidate for the office;
C.
D.
E.
F.
have ceased to receive contributions and make expenditures;
do not anticipate receiving contributions or making expenditures in the future;
have eliminated or I declare that I have no intention or ability to discharge all debts, loans received, and other obligations;
have no f~jrplus campaign funds; and
have filed all campaign stateprints required by the Political Reform Ad disclosing all reportable transactions.
I have used all reasonable diligence in preparing this statement. I have reviewed the 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.
DATE SIGNATURE OF OFFICEHOLDER OR CANDtDATE
FOR INFORMATION I~QU~IED TO IE PROVKHED TO YOU PUI~UANT TO THE INfORMATIC~t PRACTICES ACT OF 1977, SEE INF0~4ATION MANUAL ON CAMPAIGN DiejCLOeJ4JRE PROVI'~DI~ Of THE IqXfflCAt REFORM ACT,
State of California Fair Political Practices Commission