410 Statement of Organization Recipient Committee – Termination (Feb 2023)RECEIV'ED AND'FILED
the office of b Sgcremry of State
Statementof0rganization JAN802023 DateS'mp r 1 a. , , j . IRectprent Commtttee J,- 0 '; J
oTTieTal-else Only " -"StatementType ri [1 Amendment Termination-SeePart5
0 Date qualiffcation threshold met Date qualification threshold met Date of termination C U P ERTINO CITY R T II0 CITY C ER K
if applicable)
STREET CITY STATE ZIP
EMAILADDRESSIREQulRED)/ FAX (OPTIONALI
NAME OF PRINCIPAL omcesls)
AREA Cat)E/PHONE
STREET ADDRESS (NO Pa BOX)
STATE ZIP CO[)E
Attach additional information on appropriately labeled continuation sheets.
CITY AREA CODE/PHONE
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 certify under
DATE MEASIIRE PROPONENT
Executed on Rli
SIGNATURE OF CONTROLLING OtFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
SIGNATURE OF CONTROILING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (August/2018)
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