HomeMy Public PortalAboutForm 425 (Jul 1 - Dec 31, 2019)Semi -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 Practices Act of 1977.
1. Committee Information
TTEE NAME
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STREET ADDRESS (NO P.O. BOX)
Treasurer(s)
Date Stamp
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JAN -9 2020
CITY CLERN
CITY OF CLAREM
STATEMENT OF NO ACTIVITY
For Official Use Only
NAME OF TREASURER
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AILING ADDRESS
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CITY STATE ZIP CODE AREACODE/PHONE
CITY STATE ZIPCODE AREACODE/PHONE
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MAILING ADDRESS (IF DIFFERENT) NO. AND STREET
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CITY STATE ZIPCODE AREACODE/PHONE
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OPTIONAL: FAX/ E-MAIL ADDRESS
2. Period of No Activity
NAME OF ASSISTANT TREASURER, IF ANY
MAILINGADDRESS
CITY
OPTIONAL: FAX/ E-MAIL ADDRESS
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STATE ZIP CODE AREACODE/PHONE
No contributions have been received and no expenditures have been made during the period covering the dates below.. its
Check one of the following boxes and complete the year. ❑ January 1, through June 30, 20 Ouly 1, through December 31, 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 By _
DATE G SIGNATURE OF TREASURER/ASSISTANT TREASURER
FPPC Form 425 (Jan/01)
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