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HomeMy WebLinkAbout415s 'k STATEMENT OF TERMINATION FE 8 0 4 1990 ' This form must be completed by candidates, officeholders or recipient committees that wish to terminate pursuant to Government Code Section 84214. (� Form 415 1989 (Type Or Print in ink) A fOROFMCIAL USE ONLY RECIPIENT COMMITTEE: (COMMITTEES FILE - ORIGINAL AND ONE COPY OF THIS FORM WITH THE SECRETARY OF STATE AND, IF APPLICABLE. A COPY WITH THE LOCAL FILING OFFICER.) NAME OF COMMITTEE: LD. NuMAER The Campaign of Peg Moore 89 -1154 ADDRESS OF COMMITTEE: NO ANO STREET CITY STATE ZIP CODE AMA CODE /PHONE NUMBER 41747 Borealis Drive Temecula, CA 92390 (714) 699 -1973 NAME OF TREASURER: Barbara Affolter PERMANENT ADDRESS OF TREASURER: NO ANOSTMET CITY STATE ZIP COOS ANNA COUHBUNNESS PHU,A NUMBER 34121 DePortola Road Temecula, CA 92390 (714) 676 -6330 VERIFICATION I HAVE USED ALL REASONABLE DILIGENCE W PREPARING THIS STATEMENT. THIS COMMITTEE HAS CEASED TO RECEIVE CONTRIBUTIONS AND MAKE EXPENDITURES. DOES NOT ANTICIPATE RECEIVING CONTRIBUTIONS OR REPAYMENTS Of OUTSTANDING LOANS MADE TO OTHERS OR ANY OTHER RECEIPTS OR MAKING EXPENDITURES IN THE FUTURE, HAS ELIMINATED OR HAS DECLARED THAT IT HAS NO INTENTION OR ABILITY TO DISCHARGE ALL DEBTS, LOANS RECEIVED AND OTHER OBLIGATIONS, HAS NO SURPLUS FUNDS, AND HAS FILED ALL CAMPAIGN STATEMENTS REQUIRED BY THE POLITICAL REFORM ACT DISCLOSING ALL REPORTABLE TRANSACTIONS. 1 CERTIFY UNDER PENALTY Of PERJURY UNDER THE LAWS Of THE STATE OF CALIFORNIA THAT THE FOREGOING IS TRUE AND CORRECT. EXECUTEDON 1/25/90 A T Temecula, CA BY (OATEI (CITY AND STATE) (SIGNATURE Of TREASURER) EXECUTED ON AT By (DATE) (CITY AND STATE) (SIGNATURE Of CONTROL LING CANDIDATE. OFHCEHOLOER On STA EE ME ASUM PROPONEN9) EXECUTED ON AT By (OATD ICITY AND STATE) iIGNATUM Of CONTIIOLLING CANOIOATE. OF FICEHOLOER OR STATE MEASURE PROPONEN II EXECUTED ON AT By (DATE) (CITYNIDSTAIE) ISIGNAIUM Of CONTROLLING CANDIDATE, OfFiCEHOLDER OR STATE MEASURE PROPONENT) TO TERMINATE STATUS AS A CANDIDATE OR OFFICEHOLDER: (CANDIDATES AND OFFICEHOLDERS FILE AN ORIGINAL OF THIS FORM WITH THE FILING OFFICER WITH WHOM THEY FILE THE C)RIGINALS OF THEIR CAMPAIGN ST /,TE ME NTS.) NAME OF CANDIDATE OR OFFICEHOLDER: OFFICE SOUGHT OR HELD (INCLUDE LOCATION ANO DISTMcT NUMREA If APPLICABLE) Peg Moore City Council Rancho Calif./ RESIDENTIAL OR BUSINESS ADDRESS: NO.ANOSTREEI ,ITT STATE IIr CODE T 4 LEA COOERHONE NUMBER 41.747 Borealis Drive Temecula, CA 92390 (714) 676 -1960 VERIFICATION I HAVE USED ALL REASONABLE DILIGENCE IN PREPARING THIS STATEMENT. I HAVE CEASED TO RECEIVE CONTRIBUTIONS AND MAKE EXPENDITURES; DO NOT ANTICIPATE RECEIVING CONTRIBUTIONS OR REPAYMENTS Of OUTSTANDING LOANS MADE TO OTHERS OR ANY OTHER RECEIPTS OR MAKING EXPENDITURES IN THE FUTURE; HAVE ELIMINATED OR HAVE DECLARED THAT I HAVE NO INTENTION OR ABILITY TO DISCHARGE ALL DEBTS, LOANS RECEIVED AND OTHER OBLIGATIONS; HAVE NO SURPLUS FUNDS; AND HAVE FILED ALL CAMPAIGN STATEMENTS REQUIRED BY THE POLITICAL REFORM ACT DISCLOSING ALL REPORTABLE TRANSACTIONS. 1 CERTIFY UNDER PENALTY Of PERJURY UNDER THE LAWS Of THE STATE Of CALIFO A THAT OREGOIN G IS TRUE AND CORRECT. EXECUTEDON 1/25/90 AT Temecula By (PATE) (CITY AND STATE) IF 4A /O1E`4NOIDATL OR W IFICLHOLOER) NOTE: ADDITIONAL FILING OBLIGATIONS WILL BE INCURRED IF A CANDIDATE OR COMMITTEE BEGINS RAISING OR SPENDING FUNDS OR RECEIVES THE FORGIVENESS OF A LOAN OR REPAYMENTS OF LOANS MADE TO OTHERS OR ANY OTHER RECEIPTS. FDA INFORMATION REQU IRED TO BE PROVIDED TO YOU PURSUANT TO THE INFORMATION PRACTICES ACT OF 1977, SEE - INFORMATION MANUAL ON CAMPAJGN DESCLOSUAF PROVJSJONS OF THE POL)TK.AL REFORM ACT.'