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Dion Bracco - 2014 - Form 410Statement of Organization !Recipient Committee Statement Type © Initial # Not yet qualified or _I_ If Date qualified as committee 1. Committee Information NAME OF COMMITTEE Freinels of 44ion Bracco for Council 2014 rrfernds 17U2 I 9� -7v Type or print in ink ❑ Amendment ❑ Termination – See Part 5 List I.D. number: List I.D. number: Date qualified as committee Date of Termination (If applicable) STREET ADDRESS (NO P.O. BOX) IT 07 -, /l 01Y CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 9502446 408 422 -1734 MAILING ADDRESS (IF DIFFERENT) OPTIONAL: FAX/ E -MAIL ADDRESS 41 100 ; Gc> k-i COUNTY OF DOMICILE / I COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE Santa Clara Attach additional information on appropriately labeled continuation sheets. RitUfllCt� �. ST E ENT OF ORGANIZATION Date Stamp .. , ,IIM the office of the Secretary of of the State of Calitomia For Official Use Only RECEIVED AND F LED in the office of the Secretary f State of the State M Califomi 2. Treasurer and Other Principal Officers By 7- NAME OF TREASURER Michelle Bracco DATE STREET ADDRESS .a- e- Bex-4405 / V'7 . 2 fYlcf tf relic jr- CITY Gilroy STATE CA ZIP CODE 95020 AREA CODE /PHONE 408 722 -7213 NAME OF ASSISTANT TREASURER, IF ANY Dion Bracco DATE STREET ADDRESS RD>6w l `/ 17 ;� 144o v7 rte/ / t. ol ✓ CITY Gilroy STATE CA ZIP CODE 95020 AREA CODE /PHONE 408 422 -1434 NAME AND POSITION OF OTHER PRINCIPALOFFICER(S), IF APPLICABLE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT MAILING ADDRESS By CITY STATE ZIP CODE AREA CODE /PHONE 3. Verification have 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 perjury under the laws of the State of California that the foregoing is true and correct. - -�_ Executed on June 04 2014 By 7- DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER June 04 2014 Executed on By — DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By GATE 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 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 2 I.D. NUMBER Friends of Dion Bracco for City Council 2014 4. Type of Committee Complete the applicable sections. • List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled, also list the elective office sought or held, and district number, if any, and the year of the election. • List the political party with which each officeholder or candidate is affiliated or check "non- partisan." • If this committee acts jointly. with another controlled committee, list the name and identification number of the other controlled committee. NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE; PROPONENT ELECTIVE OFFICE SOUGHT AP HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY Dion Bracco 1,kOrtaviV 7 0(014 jS fPGC-� Gilroy City Councilmember 2014 ® Non - Partisan ❑ Non - Partisan a List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION AREA CODEIPHONE BANK ACCOUNT NUMBER Heritage Bank 408 842 -8310 002602746 ADDRESS CITY STATE ZIP CODE 7598 Monterey Street Gilroy CA 95020 Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD ORVEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE SU—P—P 0_R_T­_1 OPPOSE FPPC Form 410 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Statement of Organization Recipient Committee STA INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME P.D. NUMBER Friends of Dion Bracco for City Council 2014 4. Type of Committee (Continued) • • • Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ® CITY Committee ❑ COUNTY Committee ❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY Gilroy City Council Election • . List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE ❑ 1, Check box and provide the date this committee qualified as a small contributor committee. If the committee qualified as a Dale qualified small contributor committee on January 1, 2001, enter 1/1/01. 5. Termination Requirements By signing theverification, the treasurer,,assistant treasurer and /or candidate, officeholder, or proponent certify thatall of:the following conditions have been met: • This committee has ceased to receive contributions and make expenditures; • This committee does not anticipate receiving contributions or making expenditures in the future; • This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; • This committee has no surplus funds; and • This committee,has filed all campaign statements required by the Political Reform Actdisclosing all reportable transactions. -- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government Code Section 89519. FPPC Form 410 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (866/275 -3772) Statement of Organization Recipient Committee Statement Type ® Initial Not yet qualified ❑ or Type or print in ink ❑ Amendment List I.D. number: Date qualified as committee Date qualified as committee (If applicable) 1. Committee Information ❑ Termination — See Part 5 List I.D. number: Date of Termination NAME OF COMMITTEE Principal Officers Freinds of Dion Bracco for Council 2014 STREETADDRESS (NO P.O. BOX) P.O. Box 1485 Michelle Bracco CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95021 -1485 408 422 -1734 MAILING ADDRESS (IF DIFFERENT) OPTIONAL: FAX/ E -MAIL ADDRESS P.O.Box 1485 COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE Santa Clara ZIP CODE Attach additional information on appropriately labeled continuation sheets Date Stamp JUN 2014 Mr Wtrs of aCc STATEMENT OF ORGANIZATION For Official Use Only 2. Treasurer and Other Principal Officers NAME OF TREASURER Michelle Bracco STREET ADDRESS P.O.Box 1485 CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95021 408 722 -7213 NAME OF ASSISTANT TREASURER, IF ANY Dion Bracco STREET ADDRESS P.O. Box 1485 CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 408 422 -1434 NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE 3. Verification I have 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 perjury under the laws of the State of California that the foregoing is true and correct. - r Executed on June 04 2014 By DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER Executed on June 04 2014 By Executed on DATE Executed on DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME I I.D. NUMBER Friends of Dion Bracco for City Council 2014 4. Type of Committee Complete the applicable sections. OF • List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled, also list the elective office sought or held, and district number, if any, and the year of the election. • List the political party with which each officeholder or candidate is affiliated or check "non - partisan." • If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. OR NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT AP HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY Dion Bracco N '011p i., Gilroy City Councilmember 2014 Non- Partisan ❑ 'Non- Partisan • List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER Heritage Bank 408 842 - 8310' 1002602746 ADDRESS CITY STATE ZIP CODE 7598 Monterey Street Gilroy CA 95020 Primarily formed to support or oppose specific candidates or measures In a single election. List below: CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK OPPOSE FPPC Form 410 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Friends of Dion Bracco for City Council 2014 4. Type of Committee (Continued) .. . Not formed to support or oppose specific candidates or measures in a single election. Check only one box: © CITY Committee ❑ COUNTY Committee ❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY Gilroy City Council Election .. . List additional sponsors on an attachment. NAME OF SPONSOR STREET ADDRESS NO. AND STREET CITY GROUP OR AFFILIATION OF SPONSOR STATE ZIP cwt STATEMENT OF to • • • • ❑ _J� Check box and provide the date this committee qualified as a small contributor committee. If the committee qualified as a Date qualified smalrcontributor committee on January 1, 2001, enter 1 /1/01. 5. Termi nation RequirementS By signing the verification, the treasurer, assistant treasurer and /or candidate, officeholder, or proponent certify that all of the following conditions have been. .met: • This committee has ceased to receive contributions and make expenditures; • This committee does not anticipate receiving contributions or making expenditures in the future; • This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; • This committee has no surplus funds; and • This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. -- There are restrictions on the Ldisposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government Code Section 89519. FPPC Form 410 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)