410 Amendment tatement
of
t"t~l i ti
STATEMENT OF ORGANIZATION
"ruan'za"°n ~p.or print I. ink
Recipient Committee o~sam, CALIFORNIA
410
StaterflentType Olnltlal J~"~Amendment OTermlnation-SeePart5-' :~Djl~(~l~l]~l~ll' F~OfftcialUseOflly
Not yet qualilied [] or Ust I.D. number. Ust I.D. number: ~]
1236761 JLIAUG 3 1 2001 ~
I I 7 I 19 I 2001 I I By ~
Dale qualified as committee Date qualified as committee Date of Termination
1. Committee Infoh-,~ation 2. Treasurer and Other Principal Officers
NAME OF COMMITTEE NAME OF TREASURER
MARIA SMITH
DOLLY SANDOVAL FOR CITY COUNCIL SmEET ADORESS
1038 SHADY DALE
STREET ADDRESS (NO P.O. BOX) CiTY STATE ZIP CODE AREA COOFJPHONE
10720 ALDERBROOK LANE CAMPBELL CA 95008 (408) 377-3570 '
CITY STATE ZiP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY
CUPERTINO CA 95014' (408) 725-8939 ED HO~'~MAN
STREET ADDRESS
MAILINGADDRESS(IFOIFFERENT) 10720 ,~zx~L-~OOK ~
125 SOUTH MAIL-~ET STRF. ET, SUITF. 1160, SAN JOSH
q 5 ! 1 ~ crn, sram Zip COOE ~EA CCOE~PHONE
OPTIONAL: FAX I E-MAiL ADDRESS (~j~D~ ~ 95014 (408) 725--8939
(408) 255-6873 NAME AND POSITION OF OTHER PRINaPAL OFFICER(S). IF APPLICABLE
COUNTY OF DOMICILE COUNTY WHERE COMMITrEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE MAIUNG ADDRESS
SANTA CLARA COUNTY
CITY STATE ZiP CODE AREA CODFJPHONE
3. Verification
I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete/] I ceflify under penalty of
perjury under the laws of the State of Califomia that the foregoing is true ancL4:ormct.,~ ~ ~ :~/1.,~
SIC44ATLIRE OF CONTROLUNG OFFICEHOLDER. CANDIDATE. OR STATE MEASURE PROPONENT
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER. CANO~DATE. OR STATE M~RE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLUNG OFFICEHOL~ CANDIDATE, OR STATE MEASURE
FPPC Form 410 (Jan/O1)
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