Statement of Termination (Slate Mailer Organization)

(Government Code Section 84221)

Form 402 Instructions

File an original and one copy of this form with:

Secretary of State
Political Reform Division
1500 11th Street, Room 495
Sacramento, CA 95814

And, if applicable, file one copy of this form with:

The city or county filing officer, if any, with whom the organization must file its original campaing disclosure statements.


I have used all reasonable diligence in preparing this Statement. This Slate Mailer Organization has ceased to receive payments and make disbursements in connection with producing “slate mailers,” does not anticipate receiving payments or making disbursements in the future, and has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Please print and sign form.

NOTE: Additional filing obligations will be incurred if a Slate Mailer Organization receives payments or makes disbursements after this Statement of Termination has been filed.

Please press 'Create PDF Document' button below. Filled out Form 402 PDF document will be opened. Please print the document and sign at the bottom of the page.

End of the Page, Form 402 - Statement of Termination (Slate Mailer Organization)