HomeMy WebLinkAboutForm 410 - Damon Connolly for City Council 2015 TerminationIftent
Std i on
of Organ*zat*
Date Stamp
11
Recl*pl*ent Committee
Statement Type El initial ❑ Amendment
P/1 Termination — See Part 5
For Official Use Only
Not yet qualified or List I.D. number:
List I.D. number:
#
#1299779
06 12 2014
Date qualified as committee Date qualified as committee
Date of Termination
(if applicable)
M, I f
T an i nctpa,
NAME OF COMMITTEE
NAME OF TREASURER
Damon Connolly for City Council 2015
Gary Anspach
STREET ADDRESS (NO P.O. BOX)
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE
AREA CODE/PHONE
San Rafael CA 94903
San Rafael CA 94901
(
MAILING ADDRESS (IF DIFFERENT)
NAME OF ASSISTANT TREASURER, IF ANY
FAX / E-MAIL ADDRESS
STREET ADDRESS (NO P.O. BOX)
AREA CODE/PHONE
COUNTY OF DOMICILE
JURISDICTION WHERE COMMITTEE IS ACTIVE
CITY STATE ZIP CODE
Marin
San Rafael, CA
NAME OF PRINCIPAL OFFICER(S)
Attach additional information on appropriately labeled continuation sheets.
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE
AREA CODE/PHONE
I have used ail reasonable'difigence in preparing this st 'em'ent and t the best of my knowledge the information contained herein is true and complete. I certify under
penalty of perj U un er the laws of the State of Cali rnia that th or going is true and correct.
Executed on B,
DATI! S I G AT TREA URERO ASSISTANT TREASURER
Executed on q 73 q By'
V WE
SIGNATURE OF CONTROLLING OFFICER DER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (Dec/2012)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov