HomeMy WebLinkAboutHoward Miller Form 410-Termination - received from secretary of state Statement of Organization STATEMENT OF ORGANIZATION
Type or print in ink
Recipient Committee Date Stamp CALIFORNIA 410
FORM
Statement Type 0 Initial 0 Amendment D E U E For Official Use Only
//1 Not yet qualified ❑ or List I.D.number. List I.D.number:
G 1349058 NOV 13 2012
# # EIVED AND
FILED
11 12 12 in- t Ofl ice of the Secretary of State
_�� __.1_.1 �-J of the State of Caltforrna
Date qualified as committee Date qualified as committee Date of Termination By NOV 1 6 2012
(If applicable)
1. Committee Information 2. Treasurer and Other Principal OfficersEBRA BOWED
NAME OF COMMITTEE NAME OF TREASURER U
of State
Committee to Elect Howard Miller to Saratoga City Council 2012 Sandy Miller Secrets
STREET ADDRESS(NO P.O.BOX)
STREET
CITY STATE ZIP CODE
STREET ADDRESS(NO P.O.BOX)
MAILING ADDRESS(IF DIFFERENT)
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX/E-MAIL ADDRESS
NAME OF PRINCIPAL OFFICER(S)
COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE STREET ADDRESS(NO P.O.BOX)
Santa Clara County
CITY STATE ZIP CODE AREA CODE/PHONE
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
perjury under the laws of the State of California that the foregoing is true and correct. /,
11/12/12
01
Executed on By
DATE •GNATU E OF TEAS E OR ASSISTANT TREASURER
11/12/12 /
Executed on By �,
DATE Ic ATURE OF CONTR LING OFFIC=H LDER, ANDIDATE,OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
FPPC Form 410 (April/2011)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
Statement of Organization STATEMENT OF ORGANIZATION
Recipient Committee CALIFORNIA 410
FORM
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME
I.D.NUMBER
Committee to Elect Howard Miller to Saratoga City Council 2012 1349058
4.Type of Committee Complete the applicable sections.
Controlled Committee
• 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.
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD
(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 AREA CODE/PHONE BANK ACCOUNT NUMBER
Comerica Bank 408-867-6829 1894506060
ADDRESS CITY STATE ZIP CODE
13000 Saratoga Sunnyvale Road Saratoga CA 95070
Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION
CANDIDATE(S)NAME OR MEASURE(S)FULL TITLE(INCLUDE BALLOT NO.OR LETTER) (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410 (April/2011)
FPPC Toll-Free Helpline: 866/ASK-FPPC(866/275-3772)