HomeMy Public PortalAboutForm 425Semi -Annual Statement of No Activity
Type or print in ink
For use by recipient committees that have not received any contributions and have not made any expenditures
during the six-month period covered by a semi-annual statement. Candidate controlled committees formed for
an elective office may not use this form.
See the Information Manual on Campaign Disclosure Provisions of the Political Reform Act for additional information and
information required to be provided to you pursuant to the Information PracticesAct of 1977.
1. Committee Information
COMMITTEE NAME
STREET ADDRESS (NO P.O. BOX)
cJJ 90 Wt P)nh,-Fa. PA/c,
CITY STATE ZIP CODE
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET
P. n. box Yrllkl::�
CITY STATE ZIP CODE
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OPTIONAL: FAX / E-MAIL ADDRESS
2. Period of No Activity
Treasurer(s)
STATEMENT OF NO ACTIVITY
RECETVEGE�i
JAN 31 2019 For Official Use Only
CITY CLERK
CITY OF CLAREMONT
NAME OF TREASURER
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MAILINGAD ESS
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CITY STATE ZIP CODE AREA CODE/PHONE
AREA CODE/PHONE �1 � _u T �� 0 a q
NAME OF ASSISTANT TREASURER, IF ANY
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--q sal I � ip
MAILING ADDRESS /
AREA CODEIPHONE
CITY
OPTIONAL: FAX/ E-MAIL ADDRESS
No contributions have been received and no expenditures have been made during the period covering the dates below: QQ
July 1, through December 31, 20 L_
STATE ZIP CODE AREA CODE/PHONE
Check one of the following boxes and complete the year. ❑ January 1, through June 30, 20
3. Verification
I have used all reasonable diligence in preparing this statement. I have reviewed the statement and to the best of my knowledge the information contained herein is
true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on �� I - 1 By
DATEL SIGNATURE OF TREASURER/ASSISTANTTREASURER
FPPC Form 425 (Jan/01 )
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