HomeMy Public PortalAboutForm 410 TerminationStatement of Organization
Recipient Committee
Statement Type ❑ Initial
Amendment I VI Termination — See Part 5
O Not yet qualified
or
Q Date qualification threshold met I Date qualification threshold met
I.D. Number
(if applicable) 1421389
NAME OF COMMITTEE
No on Measure CR
STREET ADDRESS (NO P.O. BOX)
1495 Via Zurita Street
CITY STATE ZIP CODE AREA CODE/PHONE
Claremont CA 91711 310-849-0168
FULL MAILING ADDRESS (IF DIFFERENT)
E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL)
COUNTY
WHERE COMMITTEE 15
Attach additional information on appropriately labeled continuation sheets.
Date of termination
12 / 31 / 2019
NAME OF TREASURER
Aundre Johnson
STREET ADDRESS (NO P.O. BOX)
1686 Sumner Ave
JAN - 6 2020
CITY CLERK
ITY OF CLAREMOI\ T
For Official Use Only
CITY STATE ZIP CODE AREA CODE/PHONE
Claremont CA 91711 310-849-0168
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF PRINCIPAL OFFICER(S)
STREET ADDRESS (NO P.O. BOX)
CITY
STATE ZIP CODE AREA CODE/PHONE
.,a.._,..,3 r
A� �.•
------------
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 perjury under the laws of the State of Califo nih the foregoing is true and correct.
Executed on { (� ZQ By
DATE - SIGNATURE OF TREASURER OR ASSISTANT TREASURER
Executed on I By
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
DATE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410(August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov