HomeMy WebLinkAboutROWLES TERM 410 6/30/01 tatement of Organization
~ecipient Committee ~yp, o, p,,t~,Ink STATEMENTOFORGANIZATiON
Statement Type [] Initial
Not yet qualilied [] or
[] Amendment
List I.D. numbec.
I., ! I_ I
Date qualified as committee Date qualilied as committee
t. Committee Inforaialion
NAME OF COMMITTEE
ADDRESS (NO Re. BOX)
~ Tem~lnatlon - See Part 5
List I.D. number:
# q 30505 OI
O~ t30 t__o_L. BA~£
Date of Terming§on
JL 31 ~H t0:
SFEt. D CITY CLERK
2. Treasurer and Other Principal Officers
NAME OF TREASURER
p.
STREET ADDRESS
5531 6u n ss
STREET ADDRESS
CITY S'l-~d I: ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
- 395-
COUNTY OF DOMICILE I COUNTY VVHERE COMMITfEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE
t4
Attach additional informa#on on appropfiately labeled con#nuab~n sheets.
NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S). IF APPLICABLE
MAILING ADDRESS
CIlq' STATE ZIP CODE AREA CODEJPHONE
3. Verification
I have used all reasonable diligence in preparing this statement and to the best of my know/edge 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~ ! __
~ ./~.~-'r'~- R-~.-
execl~ on SIGNATURE OF CONTRO~.LING O~FIC~HO(.DER, CANDIDATE. OR STATE MEASURE PROPONENt
~'m By
SIGNATURE OF CONTROLLING OFFJCEHOI.~R, C.&NOIDATE. OR STATE MF. ASUR~ PROPONENT
FPPC Form 4t0 (Jan/01)
FPPC TolliFree Helpllne: 866/ASK-FPPC
Stat'eme~tt of Organization
ReCipient Committee STATEMENT OF ORGANIZATION
INSTRUCTIONS ON REVERSE
COMMI'rFEE NAME Page 2
4. Type of Committee Complete the applicable sections.
I.D. NUMBER
"List the name of each controlling officeholder, candidate, or slate 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 'non-partisan.'
· 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 OF CANOIDATE/OFFtCEHOLDERJSTATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABI
[] Non-Pa~lsan
[] Ncn-Partisan
List the financial institution where the campaign bank account is located (controlled candidate election committees only)
NAME OF FINANCIAl. INSTITUTION AREACODE/PHONE BANI( ACCOUNT NUMBER
i m.n , 0-%
ADDRESS
FPPC Form 410 (Jan/01)
FPPC Toll-Fr~a Helpllne: 866/ASK-FPPC
Sta.tement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
STATEMENT OF ORGANIZATION
P~ge 3
I.D. NUMBER
4. Type of Committee (continuad)
E~'~'~'~' ~l~' '(i~ 'z'~"~'~ ~'z" '" ~ (=~'~ Not formed to support or oppose specific candidates or measures in a single*election. Check only one box:
[] CiTY Committee [] COUNTY Committee [] STATE Committee
PROVIDE BRIEF DES~,t~zP i iON OF ACTIVITY
List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE
~"~lE'~'~'''z'~Ta""'"'11~=J~ [] ! I Checkboxandprovidethedatethiscornmitteequalifiedasasmallcontdb~to~-committee. If~hecommitteequalifiedasasmall
Date qualified con~butor committee on January 1,2001, enter 1/1/01.
5. Termination Requirements By signing the verification, thetreasurer, assistant t~easurer and/or candidate, officeholder, or i~oponent certifythat aJlofthe following conditions 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.
-- Additional filing obligations will be incurred if. after terminating, the committee receives or spends any funds, or receives the forgiveness of a loan,
repayments of loans made to othem, or any other receipts.
FPPC Form 410 (Jan/01)
FPPC Toll-Free Helpllne: 866/ASK-FPPC