HomeMy WebLinkAboutCOUCH 410 TERM 12/31/10Statement of Organization
Recipient Committee
Statement Type D Initial
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Date qualified as committee Date qualified as committee
(it OPPICENG)
RECEIVED AND FILED
in the office of t
of the S e of C NIa"a
W Termination - See Part $ AN
List I.D. number.
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Date of Termination
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COUNTY
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IS ACTIVE IF
Attach additional information on appropriately labeled continuation sheets.
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Committee Information 2. Treasurer and Other Principal Officers
NAME OF COMMITTEE NAME OF TREASURER
By
SIGNATURE OF N ROLLING OFFICEHOLDER. R STATE MEASURE PROPONENT
FPPC Forth 410 (April/2011)
FPPC Toll-Free Helpline: 8661ASK-FPPC (8661275-3772)
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE OR STATE MEASURE PROPONENT
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE
V/J>
STATEMENT OF ORGANIZATION
Page 2
I.D. NU
4. Type of Committee Complete the applicable sections.
• 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 "non-partisan."
• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
-
avt DNY/D G04
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Non-Partisan
❑ Non-Partisan
e List the financial institution where the campaign bank account is located (controlled "candidate election" committees only)
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
f -Gf1r lw, 304- st7i
ADDRESS CITY STATE ZIP CODE
. Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER)
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE
SUPPORT OPPOSE
FPPC Form 410 (April/2011)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
Statement of Organization STATEMENT OF ORGANIZATION
Recipient Committee CALIFORNIA A 111
INSTRUCTIONS ON REVERSE
Page 3
8*^! 90
4. Type of Committee (Continued)
General Purpose Committee 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 DESCRIPTION OF ACTIVITY
List additional sponsors on an attachment.
NAME OF SPONSOR
STREETADDRESS NO.AND
GROUP OR AFFILIATION OF SPONSOR
CITY
STATE
❑ -J~
Date qualified
5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that all of the. 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.
- 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 Section 18680 and FPPC Regulation 18521.5.
FPPC Forth 410 (ApriU2011)
FPPC Toll-Free Helpline: 86WASK-FPPC (8661275-3772)
•
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CALIFORNIA
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CITY COUNCIL
Harvey L. Hall
Mayor
David Couch
rice-Mayor
Wart) 4
Rudy Salas, Jr.
Ward 1
Susan M. Benham
Ward 2
Ken Weir
Ward 3
Harold W. Hanson
Warr 5
Jacquie Sullivan
Weird 6
Russell Johnson
Ward 7
December 28, 2011
Secretary of State
Political Reform Division
P.O. Box 1467
Sacramento, CA 95814
Re: Transmittal of Form 410 Termination - Friends of
David Couch
To Whom It May Concern:
I recently discovered that I had not filed a closing Form 410 and
a closing Form 460 for the committee named "Friends of David
Couch".
These two forms (the closing 410 and the closing 460) should
have been filed on January 30, 2011. Only the Form 410 needs
to be forwarded to the Secretary of State.
I apologize for any inconvenience this may have caused.
Thank you for your assistance.
Best eg r s,
David Couch,
Councilmember, Ward 4
S:\CouncihLETTERS\COUCH\7TH STANDARD ROAD IMPROVEMENTS. doc
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