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HomeMy WebLinkAboutHoward Miller - Form 410 - TerminationStatement of Organization Recipient Committee Statement Type ❑ Initial Not yet qualified ❑ or Date qualified as committee 1. Committee Information Type or print in ink ❑ Amendment List I.D. number: Date qualified as committee (If applicable) ® Termination — See Part 5 List I.D. number: #1349058 11 12 12 Date of Termination NAME OF COMMITTEE Committee to Elect Howard Miller to Saratoga City Council 2012 STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE /PHONE Saratoga CA 95070 MAILING ADDRESS (IF DIFFERENT) OPTIONAL: FAX/ E -MAIL ADDRESS COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE Santa Clara County Attach additional information on appropriately labeled continuation sheets Date Stamp I � NOV 13 2012 [ 2. Treasurer and Other Principal Officers NAME OF TREASURER Sandy Miller STATEMENT OF ORGANIZATION For Official Use CITY STATE ZIP CODE AREA CODE /PHONE Saratoga CA 95070 NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE NAME OF PRINCIPAL OFFICER(S) STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE /PHONE 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 perjury under the laws of the State of California that the foregoing is true ar 11/12/12 Executed on DATE 11/12/12 Executed on DATE Executed on DATE Executed on DATE By By By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT FPPC Form 410 (April /2011) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE STATEMENT OF ORGANIZATION COMMITTEE NAME I.D. NUMBER Committee to Elect Howard Miller to Saratoga City Council 2012 1349058 4. Type of Committee Complete the applicable sections. • List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled, also list the elective office sought or held, and district number, if any, and the year of the election. • List the political party with which each officeholder or candidate is affiliated or check "non- partisan." • If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. ELECTIVE OFFICE SOUGHT OR HELD NAME OF CAN MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY Howard Miller Saratoga City Council 2012 ® Non - Partisan ❑ Non - Partisan • List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION Comerica Bank AREA CODE /PHONE 408 - 867 -6829 LINT NUMBER ADDRESS CITY STATE ZIP CODE 13000 Saratoga Sunnyvale Road Saratoga CA 95070 Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION E (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE SUPPORT IOPPOSE FPPC Form 410 (April /2011) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Committee to Elect Howard Miller to Saratoga City Council 2012 4. Type of Committee (Continued) Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY List additional sponsors on an attachment. NAME OF SPONSOR EETADDRESS NO.AND ❑ I Date qualified INDUSTRY GROUP OR AFFILIATION OF SPONSOR STATE ZIP CODE STATEMENT OF ORGANIZATION 1349058 5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and /or candidate, officeholder, or proponent certify that all of the following conditions have been met: • This committee has ceased to receive contributions and make expenditures; • This committee does not anticipate receiving contributions or making expenditures in the future; • This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; • This committee has no surplus funds; and • This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. -- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government Code Section 89519. -- Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511 - 89518, and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5. FPPC Form 410 (April /2011) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)