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HomeMy WebLinkAboutForm 410 - Randy Warren for City Council 2013 (2013-09-26) TerminationSA tatement of Organization Recipient Committee Statement Type 0 Initial Not yet qualified [] or F1 Amendmem List I.D. number: M 08 06 2013, Date qualified as committee Date qualified as committee (if applicable) 0 Termination -See Part 5 List J.D. number: #1359636 12 25 2013 Date of Termination I I T STATE ZIP CODE AREA CODE/PHONE SAN RAFAEL CA 94903 ( MAILING ADDRESS (IF DIFFERENT) FAX / E-MAIL ADDRESS INFO@RANDYWARRENFORCITYCOUNCIL.COM UP112,11 IT 01191711CILL JURISDICTION WHERE COMMITTEE IS ACTIV—E 7"Tn!n MARIN ,SAN RAFAEL, MARIN, CA Attach additional information on appropriately labeled continuation sheets, STREET ADDRESS (No P.O, BOX) CITY STATE ZIP CODE AREA CODE/PHONE NAME OF PRINCIPAL OFFICER(S) CITY STATE ZIP CODE AREA CODE/PHONE . . ...... I have used all reasonable diligence' in preparing this statement and to the bg!st of my knowledRe the information ' penaltyI S contained herein is true and complete. I certify under go of perjury under the laws of the State of California that the fore I i true an c re t. 9 Executed on 12/28/2013 . Bv DATE Executed on 12/28/2013 RIM W SIGNATURE OYA'5ASURER OR ASSISTANT TREASURER :16NAIURE O'CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on DATE By By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (Dec/2012) FPPC Advice.- advicePfppc.ca.gov (866/275-3772) www.fppc.ca.gov Sbtement of Organization Recipient Committee INSTRUCTIONS ON REVERSE N Aftiv, I kh I Iona 210 FAM, I RANDY WARREN FOR CITY COUNCIL 2013 * All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION CITIBANK AREA CODE/PHONE BAN - K ACCOUNT NUMBER ( 1205340060 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. NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD - 11 (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION I CITY COUNCIL, CITY OF SAN RAFAEL Primarily Formed ComrrtitfeePrimarily formed to support or oppose specific candidates or measures in a single election. List beloi 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) PARTY 21 Nonpartisan WIN FPPC Form 410 (Dec/2012) FPPC Advice: advice@fppc.ca.gov (866/275-3772) wwW.fppc.ca.gov Shatement of Organizatior. Recipient Commiftee INSTRUCTIONS ON REVERSE COMMITTEE NAME RANDY WARREN FOR CITY COUNCIL 2013 x- 7 7-77 General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check onlone box: El CITY Committee y COUNTY Committee n STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY =MMM19 List additional sponsors on an attachment. Sponsored Committee NAME OF SPONSOR STREET ADDRESS NO. AND STRFFT INDUSTRY GROUP OR AFFILIATION OF SPONSOR Ll I Y STATE ZIP CODE Small Contributor Committee Date qualified W"M .vertsur t 77= ...... -`7777777- ',777;, t oil h`vio b -Oridld' h 'W 't Of A or' , me as B d/' ate 09 -n- C h% • .1[df th pen: 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 subject to Elections Code Section 18680 and FPPC Regulation 18521.5." - 89518, and are FPPC Form 410 (Dec/2012) FPPC Advice: adv1ce@i)fppc.ca.gov (866/275-3772) www.fppc.ca.gov