2011 - Form 410 Termination
Statement of Organization
Recipient Committee
Type or print in ink
STATEMENT OF ORGANIZATION
Dale Stamp
CALIFORNIA 410
FORM
Statement Type
o Amendment
List 1.0. number:
181 Termination - See Part 5
List 1.0. number;
For Official Use Only
o Initial
Not yet qualified 0 or
REC IVED AND FILED
in the 0 Ice of the Secretary of State
o the State of California
~3
# 125190
07 , 22 ,--11-
Date of Termination
#
, ,-
Date qualified as committee
_-1 ,-
Date qualified as committee
(If applicable)
DEBRA BOWEN
Secretary of State
1, Committee Information
NAME OF COMMITTEE
Friends of Dion Bracco for Gilroy City Council 2010
STREET ADDRESS (NO P.O. BOX)
1657 EI Dorado
CITY
Gilroy
MAILING ADDRESS (IF DIFFERENT)
STATE
ZIP CODE
AREA CODE/PHONE
CA
95020
408422-1734
P.O. Box 1485 Gilroy CA 95021-1485
OPTIONAL: FAX / E-MAIL ADDRESS
COUNTY OF DOMICILE
COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE
Santa Clara
Attach additional information on appropriately labeled continuation sheets.
AUG 1 0 2011
2. Treasurer and Other Principal Officers
NAME OF TREASURER
Dion Bracco
STREET ADDRESS (NO P.O. BOX)
1657 EI Dorado Drive
CITY
ZIP CODE
95020
AREA CODE/PHONE
408422-1734
STATE
Gilroy
NAME OF ASSISTANT TREASURER, IF ANY
CA
STREET ADDRESS (NO P.O. BOX)
CITY
STATE
ZIP CODE
AREA CODE/PHONE
NAME OF PRINCIPAL OFFICER(S)
STREET ADDRESS (NO P.O. BOX)
CITY
STATE
ZIP CODE
AREA CODE/PHONE
3. Verification
I h~ve 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
pe~ury under the laws of the State of California that the foregoing is true and correct.
Executed on 07/22/2011 By \ ~ --:.:;;;~ -\ ~ ~
DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER
Executed on
07/22/2011
DATE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
By
DATE
Executed on
By
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (JuneI09)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
STATEMENT OF ORGANIZATION
Dab! S~mp
^
tL~
JUL 2011
Cln' CLERKS Of.
."
Statement of Organization
Recipient Committee
181 Termination - See Part 5
List 1.0. number:
Type or print in ink
o Amendment
List I. D. number
o Initial
Not yet qualified
Statement Type
o
125190
07 , 22 , 11
Date of Termination
#
#
----1 ,
Date qualified as committee
(If applicable)
or
, /
Date qualified as committee
Officers
2. Treasurer and Other
NAME OF TREASURER
Dion Bracco
STREET ADDRESS (NO P.O. BOX)
1657 EI Dorado Drive
Gilroy City Council 2010
Committee Information
NAME OF COMMITTEE
Friends of Dion Bracco for
1
AREA CODE/PHONE
408 422-1734
ZIP CODE
95020
STATE
CA
CITY
Gilroy
N'A'M'EOF ASSISTANT TREASURER, IF ANY
AREA CODE/PHONE
408422-1734
ZIP CODE
95020
STATE
CA
STREET ADDRESS (NO P.O. BOX)
Dorado
1657 EI
CITY
Gilroy
MAILING ADDRESS
AREA CODE/PHONE
STREET ADDRESS (NO P.O. BOX)
(IF DIFFERENT)
P.O. Box 1485 Gilroy CA 95021-1485
OPTIONAL: FAX / E-MAILADDRESS
ZIP CODE
STATE
CITY
NAME OF PRINCIPAL OFFICER(S)
COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE
COUNTY OF DOMICILE
STREET ADDRESS (NO P.O. BOX)
AREA CODE/PHONE
ZIP CODE
STATE
CITY
Santa Clara
certify under penalty of
the information contained herein is true and complete.
Attach additional information on appropriately labeled continuation sheets.
Verification
I have used all reasonable diligence in preparing this statement and to the best of my knowledge
perjury under the laws of the State of California that the foregoing is true and correct.
07/22/2011 By
3.
Executed on
SIGNATURE OF TREASURER OR ASSISTANT TREASURER
l\
07/22/2011
i5Ai'E
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT
By
Executed on
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT
By
DATE
Executed on
SIGNATURE of CONTROLLING OFFICEHOLDER. CANDIDAtE, oR STATE MEASURE PROPONENT
FPPC Form 410 (June/09)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
By
DATE
Executed on