HomeMy WebLinkAboutBUSTAMANTE 415 ecipient Committee
Statement of Termination
This form must be completed by recipient committees
that are eligible to terminate pursuant to Government
Code Section 84214.
Type or print in ink.
Recipient Committee Information
NAME OF COMMITTEl[
I.O. NUMBER
S. ROy BURTAMANTF,
ADDRESS OF COMMITTEE NO, AND STREE~
bakersfield CA, g~RO~
CITY STATE ZIP CODE
AREA CODE/DAYTIME PHONE NUMBER
805 872 9385
WHERE TO FILE:
File original and oN copy o/thk form with:
Secretary of State
Political Reform Division
P.O. Box 1467
Sacramento, CA 95812-1467
And. · applicable, flit Gate copy of this form with:
The city Or county officer, if any, who receives the
com mlttee's campa~n disclosure statements.
II Treasurer Information
NAME OF TREASURER
BAKERSFIELD, CA.
ct~
III
RECIPIENT COMMITTEE
STATEMENT OF TERMINATION
pANOR~ n~
..... ~O7~STREET
93306
STATE ZIP CODE
AREA CODE/DAYTIME PHONE NUMBER
805 872 9385
Effective Date of Termination
DATE FILING OBLIGATIONS WERE COMPLETED
IV
FFB 01 1999
Verification
A. This committee has ceased to receive contributions and make expenditures; :
B. This committee does not anticipate receiving contributions or making expenditures in the future; "
:
C. This committee has eliminated or declares that it has no intention or ability to discharge all debts, loans received, and other obligations;
D. This committee has no surplus funds; and ,
E. This committee has filed all campaign statements required by the Political Reform Act 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
heroin 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 At
DATE CITY AND SLATE
Executed on At
OAT[ CITY AND STATE
Executed On
OATE
Executed aa~f_/~ o ~/-/'If/q
DATE
At
CITY AND STATE
At
By
SIGNATURE Of TREASURER
By
SIGNATUKE Of CONTROLLING OfFICEHOLDER. CANDIDATE. OR STATE MEASURE PROPONENT
By
SIGNATURE Of CONTROLLING Of FICEHOtDER, CANDIDATE, OR STATE MEASURE PROPONENT
By ' ~ ""~' "'~t~''' ""~/~c ~
a '~NATURE Of TROLLING EHOLDER. CANDIDATE. OR STATE MEASURE PROPONENt
FOR INFORMATION REQUIRED TO 8E PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT Of 1977, SEE iNFORMATiON MANUAL Old CAMPAIGN DISCLOSURE PROVISIONS Of THI~ POLITICA~ REFORM ~
State of California Feir Political Practices Commission