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HomeMy WebLinkAbout410 03/06/2017 Statement of Organization Recipient Committee - Gina Phillips TerminationStatement of Organization Recipient Committee statement,Type. ❑ Initial ❑ Amendment List I.D. number, Not yet qualified❑ or p :Date qualified as committee .Date qualified as committee (Rappli.ble) GINA PHILLIPS FOR CITY COUNCIL 2016 2) Termination — See Part 5 List I.D. number: 1384081 11 109 /2016 Date of Term in ad on STREET ADDRESS (NO PO BOX) CITY STATE ZIP CODE AREA CODE /PHONE MAILING ADDRESSHF DIFFERENT) FAX / EMAIL ORANGE CITY OF SEAL BEACH Attach additional information on appropriately labeled continuation SQa-? � cvt t,-- Date Stamp RCEIVEDP in t e office of the SI of the Slate of JAN 09 2011L I JAN 1 3120 MAR 06 20 D NAME OF TREASURER CITY OF SEAL BEACH THOMAS W. STRETZ STREET ADDRESS (NO PO BOX) 4291 HOWARD AVE CITY - STATE ZIP CODE AREA CODE /PHONE CA 90720 (562)650 -0212 NAME OF ASSISTANT TREASURER, IF ANY GINA PHILLIPS STREET ADDRESS .'O PO. BOxi 4725 CANDLEBERRY AVE CITY STATE ZIP CODE AREA CODE /PHONE SEAL BEACH CA 90740 (562)430 -9497 NAME OF PRINCIPAL OFFICER(S) ADDRESS (NO P.O. aop CITY STATE ZIP CODE AREA CODE /PHONE I have used all reasonable diligence in preparin his statement d to the best of my knowledge the information contained herein is true and com penalty of perjury under t e laws of the St EOFTPEASUPEfl OPABSISigNiTREASURER Executed on a/ ev Executed on By ' DATE SIGNATURE OF CONTROLLING OFFICEHOLOEP, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By DATE. SIGNPTURE OF CONLROLLING UFFICEHOLDER, CAN DIpgi E, ORSTATEMEASURE PROPONENT FPPC Form 410 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) 'www.fppc.ca.gov Statement of Organization Recipient Committee Statement Type ❑ Initial Not yet qualified ❑ or Date qualified as committee ❑ Amendment List LU. number; Dace qualified as committee In anponoea 1. Committee Intormation NAMED IT CO MM IT IEE GINA PHILLIPS FOR CITY COUNCIL 2016 © Termination — See Part List I . number: n1384081 11_/ 0 9 /2016 Date of Termination GINA PHILLIPS STREET ADDRESS INO V n. COX) Clry STATE ZIP CODC AntACOD[ /PHONE LOUT I V OF DOMICILI: IIIXISNC Itlry wrvf R[wmixi [eanu ivc ORANGE CITY OF SEAL BEACH Attach additional information on appropriately labeled continuation Verification I have used all reasonable diligence in prc penalty of perjury un`d1er t e laws of the S Executed on 7 r� eY rl I c Executed on / //7a v BY Dorf Executed nn NAMF OF PRINCIPAL ORFICER)S) STREI T ADDRESS (NO RD BOY) CITY SIAlC 111, CODE AREA CO DE /C 11 ONE is true and correct. By 51[iNnF11RE Dr [ONIROLLINn ()I:f ICI:H[I LDER CANDInAIE, OR STATE MCAFURr PRORUNFNT Executed on By DATC 9ONAf IIIV OF CONTROLLING ALL CCIIOIDATA. CANDIDATE, OR STAFF MCASURI PROPONCNI FPPC Form 410 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov