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Committee for Measure F Quality of Life - Form 410Statement of Organization
Recipient Committee
Statement Type `4 Initial ❑ Amendment ❑ Termination — See Part 5
Not yet qualified ❑ or List I.D. number: List I.D. number:
Date qualified as committee Date qualified as committee Date of Termination
(Il applkable)
1. Committee Information 2. Treasurer and Ot
NAME OF COMMITTEE /►�/ { j NA EO�REASURER
C'arrl r✓I f i '' ~ rn s ��l,2t� F 'or c 1
STREET ADDRESS (NO P.O. BOXI STREET ADDRESS (NO P.O. BOX)
?
MAILING ADDRESS (IF DIFFERENT)
9/1 Al 15,
FAX / E-MAIL ADDRESS
COUNTY OF DOMICILE I IURISDICTION WHERE COMMITTEE IS ACTIVE
sQAvr.4 G L 1* 12 4 ell-)' (I ltz r r c Rv y
Attach additional information on appropriately labeled continuation sheets.
Date Stamp
ck
er Principal Officers
For Official Use Only
CITY
STREET ADDRESS (NO P.O. 801). °'r -
-
Verification ..1
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 tunder the laws of the
PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on I By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (Dec/2012)
FPPC Advice: advice@fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
r 45u�c
• All committees must list the financial institution where the campaign bank account is located.
Page 2
I.D. NUMBER
NAME OF FINANCIAL INSTITUTION AREA ODE /PHONE BANK ACCOUNT NUMBER
►' nn c� �(. nl'� qN > `7��.- 171 �� I b(��- 5 L/
ADDRESS
T5 a 7 fflMWQq 5ACZe-t
T Type of Committee Complete the applicable sections.
CITY STATE ZIP CODE
C'1 c2oY CA '115-000
• 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 "nonpartisan."
• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
ELECTIVE OFFICE SOUGHT OR HELD
NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
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)
CANDIDATES) OFFICE SOUGHT OR HELD OR MEASURES) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
FPPC Form 410 (Dec/2012)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
SUPPORT
OPPOSE
SUPPORT
O[n
FPPC Form 410 (Dec/2012)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
U
Statement of Organization k�?
Recipient Committee
Statement Type m Initial ❑ Amendment
Not yet qualified ® or List I.D. number:
/) —] 0 � O Date stamp CALIFORNIA '
✓/mil / 4
RECEIVED AND FIL FORM
❑ Termination — See Part 5 in the office of the Secretary of S
List I.D. number: of the State of California _
Date qualified as committee Date qualified as committee Date of Termination
(If applicable)
1. Committee Information
NAME OF COMMITTEE
Committee for Measure F Quality of Life
STREET ADDRESS (NO P.O. BOX)
MAILING ADDRESS (IF DIFFERENT)
Same
FAX / E -MAIL ADDRESS
WHERE COMMITTEE IS ACTIVE
Santa Clara I City of Gilroy
Attach additional information on appropriately labeled continuation sheets
AUG 2 8 2014
Treasurer and Other Principal Officers
NAME OF TREASURER
Sara Humphrey Nino
STREET ADDRESS (NO P.O. BOX)
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE /PHONE
NAME OF PRINCIPAL OFFICER(S)
Donald F. Gage
STREET ADDRESS (NO P.O. BOX)
3. Verification
I have used all reasonable diligence in preparing
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 (Dec /2012)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
It
I.D. NUMBER
COMMITTEE NAME' , -
Committee for Measure F Quality of Life
• All committees must lit the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
Dinnnnlc R7nle
ADDRESS
7597 Monterey Street
(408)762 -7171
CITY
Gilroy
BANK ACCOUNT NUMBER
201002854
STATE ZIRCODE
CA 95020
• 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 "nonpartisan."
• If this committee -acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
ELECTIVE OFFICE SOUGHT OR HELD
NeMF.or CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION
PARTY
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S),OFFICE SOUGHTOR HELD OR MEASURE(S)JURISDICTION
•I........ n0 I CTTC01 ........... .•.TV nn rn11.ITV Ac ADDI IrARI. EI rNFrC ONF
-
SUPPORT OPPOSE -
0
Comrnittee for Measure F Quality of Life
Gilroy
SUM On
FPPC Form 410 (Dec /2012)
FPPC Advice: advice @fppc ca- gov.(866 /275 -3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME!
Committee for Measure F Quality of Life
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREACODE /PHONE BANK ACCOUNT NUMBER
Pinnacle Bank (408)762 -7171 201002854
CITY STATE ZIP CODE
ADDRESS
7597 Monterey Street Gilroy CA 95020
• 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 "nonpartisan."
• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
ELECTIVE OFFICE SOUGHT OR HELD YEAR OF ELECTION
NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE)
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATES) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CANDIDATE(S) NAME OR MEASURE(S),FULL TITLE (INCLUDE BALLOT NO.OR.LETTER)
Committee for Measure F Quality of Life -
Gilroy
PARTY
❑ Nonpartisan
Nonpartisan
CHECKONE
SUPPORT I OPPOSE
OPEUSE
FPPC Form 410(Dec /2012)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
N
i
Statement of Organization
Recipient Committee
Statement Type [✓] Initial
Not yet qualified ❑ or
09 (22 /2014
Date qualified as committee
NAME OF COMMITTEE
2, Z o 2, 3
❑ Amendment ❑ Termination — See Part 5
List I.D. number: List J.D. number:
l I
Date qualified as committee
(R applicable)
M
Date of Termination
Gilroy Citizens Opposing Measure F
STREET ADDRESS (NO P.O. BOX)
FAX / E -MAIL ADDRESS
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVF
Monterey Santa Clara
Attach additional information on appropriately labeled continuation sheets.
I have used all reasonable diligence in preparing this statement a
penalty of perjury undgr the laws of the State
correct.
DATE By
SIGNATURE OF CONTROLLING 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 (Dec /2012)
FPPC Advice: advice@fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON- REVERSE
COMMITTEE NAME Page 2
I.D. NUMBER
Gilroy Citizens Opposing Measure F
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE /PHONE BANK ACCOUNT NUMBER
Pinnacle Bank (408)842 -8200 201003928
ADDRESS
CITY STATE ZIP CODE
7597 Monterey St Gilroy CA 95020
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 "nonpartisan."
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 OR HELD
(Imn 11f1F IIIGTRIrT All I —. - n— iron - vc -r 11 11r....1
Prim
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURES) 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 ONE
SUPPORT OPPOSE
Measure F Quality of life TAX Gilroy
El R1_
SU�T D0
FPPC Form 410 (Dec /2012)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Statement of Organization
• Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Gilroy Citizens Opposing Measure F
' 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
List additional sponsors on an attachment.
NAME OF SPONSOR
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
ET ADDRESS NO. AND STREET CITY STATE - ZIP CODE
Page
I.D. NUMBER
Date gpalified
y, 3 '= w r eaAon thetfeas4rerassfstant <treasurerand ,or candidate o_fficeholderj or proponent cerfify that all of the following condtnons have been mett y
5 Termirrafion Re wrernents - By signing the
• 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 disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government
Code Section 89519.
Leftover funds of ballot measure committees maybe used for political, legislative or governmental purposes under Government Code Sections 89511- 89518, and are
subject to Elections Code Section 18680 and FPPC Regulation 18521.5.
FPPC Form 410 (Dec /2012)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc:ca.gov