CA Form 410 Termination Dave Emenhiser for RPV City Council 2019 Statement of Organization } : CALIFORNIA 41 0
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CITY OF RANCHO P t? .
Statement Type ❑Initial 0 Amendment Termination—See Part 5 For Official Use Only
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Q Date qualification threshold met Date qualification threshold met hof ermi atione:26 -- ---....--
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CITY CLERK'S ,4�e-pi. i‘,
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NAME OF COMMITTEE NAME OF TREASURER
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STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE
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CI y . ;/ ZIP CODE AREA CODE/PHONE NAME OF ASS NT TREASURER,IF ANY
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FULL MAILING ADDRESS(IF DI F RENT) STREET AD RE4)P.O.BOX)
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E-MAIL ADDRESS(REQUIRED)/FAX(OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE
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COU TY OF DOMICILE JURISD TION WHERE COM ITTEE IS,0....2440 NAME OF PRINCIPAL O FICER(S)
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CITY/VX STATE ZIP CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
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I have used all reasonable diligence in preparing this statement and to the best o .ay knowledge the information contained herein is true and complete. I certify under
penalty of perjury under the laws o e State of Calif la'that the foregoi .:�• rue and correct.
Executed on
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ATE _ IGNATURE OF TREASURER OR ASSISTANT TREASURER
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Executed on By
DATE MOIPPSIGNATURE OF CONT••LLING OFFICEHOLDER,CANDIDATE,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(August/2018)
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www.fppc.ca.gov