410 Termination
Statement of Organization
Recipient Committee
#
# 1279538
~~ 2006
Date of Termination
rnJ lE ~ re ~ta~g [E
~UI
"'L '.)
dJ .J
2'J06
'tYpe or print In Ink
Statement Type 0 Initial
Not yet qualified 0 or
o Amendment
List 1.0. number:
iii Termination - See Pa
List 1.0. number:
----1----1_
Date qualified as committee
----1----1_
Date qualified as committee
(If applicable)
1. Committee Information
NAME OF COMMITTEE
Citizens for Orrin Mahoney
STATE
ZIP CODE
AREA CODE/PHONE
2. Treasurer and Other Principal Officers
NAME OF TREASURER
Carolyn Krizek-Mahoney
STREET ADDRESS
10940 Miramonte Road
CllY
Cupertino
NAME OF ASSISTANT TREASURER. IF Am
STATE
ZIP CODE
AREA CODE/PHONE
408-725-1767
STREET ADDRESS (NO P.O. BOX)
10940 Miramonte Road
CllY
Cupertino
MAILING ADDRESS (IF DIFFERENT)
P.O. Box 1523. Cupertino, CA 95014
OPTIONAL: FAX I E-MAil ADDRESS
CA
95014
CA
95014
408-725-1767
STREET ADDRESS
CllY
STATE
ZIP CODE
AREA CODE/PHONE
NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE
COUNlY OF DOMICilE
COUNlY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNlY OF DOMICilE
MAILING ADDRESS
Santa Clara
CllY
STATE
ZIP CODE
AREA CODElPHONE
Attach additional information on appropriately labeled continuation sheets.
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 certify under penalty of
pe~ury under the laws of the State of California that the foregoing is true and correct.
Executed on July 31,2006 By
DATE
Executed on July 31,2006 By
DATE
Executed on By
DATE
Executed on By
DATE
lLlNG OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (January/OS)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)