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Peter Leroe-Munoz - Form 410 - 2014 AmendmentStatement of Organization Recipient Committee Statement Type ❑ Initial Not yet qualified ❑ or Date qualified as committee ❑ Amendment List I.D. number: #1327985 06 14 /2010 Date qualified as committee (If applicable) 1. Committee Information NAME OF COMMITTEE Peter Leroe -Munoz for City Council 2014 STREET ADDRESS (NO P.O. BOX) 8200 Kern Avenue, Apt # 1 -202 ❑ Termination — See Part 5 List I.D. number: # Date of Termination CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95045 (408)427 -4697 MAILING ADDRESS (IF DIFFERENT) FAX / E -MAIL ADDRESS peterforgilroy2014@gmail.com COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE Santa Clara Date Stamp For Official Use Only 2. Treasurer and Other Principal Officers NAME OF TREASURER Peter Leroe -Munoz STREET ADDRESS (NO P.O. BOX) 8200 Kern Avenue, Apt # 1 -202 CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 (408)427 -4697 NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE NAME OF PRINCIPAL OFFICER(S) Peter Leroe -Munoz Attach additional information on appropriately labeled continuation sheets. STREET ADDRESS (NO P.O. BOX) 8200 Kern Avenue, Apt # 1 -202 CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 (408)427 -4697 3. Verification I have used all reasonable diligence in preparing this statement and to the best of my knowledge t e information contained herein is true and complete. I certify under penalty of perjury under the laws of the State of California that regoing is and correct. Executed on L O. db • Zo/44 By 2' DATE I OF TREASURERA ASSISTANT TREASURER Executed on I A 06 . 7 01� c gy DA SIGNATURE OF TROLLING FFICEH LDER, 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 PROPONENI 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 Page 2 COMMITTEE NAME I.D. NUMBER Peter Leroe -Munoz for City Council 2014 11327985 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION Pinnacle Bank ADDRESS AREA CODE /PHONE (408)848 -7214 CITY BANK ACCOUNT NUMBER 201003589 STATE ZIP CODE 7597 Monterey Street Gilroy CA 95020 4. ?T,ypero +Colmmlttee� Compl 'etethe'appllcablersectlons _ �� � � <� • 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 (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY Peter Leroe -Munoz City Council Member 2014 ® Nonpartisan SUPPORT ❑ Nonpartisan rPrimarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATES) NAME OR MEASURES) FULL TITLE (INCLUDE BALLOT NO. OkLETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASUREW 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 F-1 OPPOSE EL SUPPORT OPPOSE FPPC Form 410 (Dec /2012) FPPC Advice: advice @fppc.ca.gov.(866 /275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee Statement Type ❑ Initial Not yet qualified ❑ or / --/ Ir Date qualified as committee © Amendment List I.D. number: #1327985 06 / 141 2010 Date qualified as committee (If applicable) ❑ Termination — See Part 5 List I.D. number: Date of Termination Date Stamp For Official Use Only RECEIVED AND FIL �a in the office of the Secretary of State of the Stnte of California OCT 2014 OCT 10 2014 CITY CLERKS OTHCC GILROY, CA 1` rCom"rnitte and Other: Principal, Of NAMEOF COMMITTEE NAME OF TREASURER Peter Leroe -Munoz for City Council 2014 Peter Leroe -Munoz STREET ADDRESS (NO P.O. BOX) 8200 Kern Avenue, Apt # 1 -202 CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95045 (408)427 -4697 MAILING ADDRESS (IF DIFFERENT) FAX / E -MAIL ADDRESS 14 @amail.com COUNTY OF DOMICILE I IURISDICTION WHERE COMMITTEE IS ACTIVE Santa Clara STREET ADDRESS (NO P.O. BOX) 8200 Kern Avenue, Apt # 1 -202 CITY STATE ZIP CODE Gilroy CA 95020 AREA CODE /PHONE (408)427 -4697 NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE NAME OF PRINCIPAL OFFICER(S) Peter Leroe -Munoz Attach additional information on appropriately labeled continuation sheets. STREET ADDRESS (NO P.O. 80X) 8200 Kern Avenue, Apt # 1 -202 CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 (408)427 -4697 3 ,Fberi cats 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 fo going . is true an rrect. Executed on l0 . of, . Zol 4 By DATE SIGNATUR F ASURERO ASSISTANT TREASURER Executed on r c7. ob. Zoyi By DATE SIGNATURE OF CONTROLL N OFFICEHO , CANDIDATE, OR STATE MEASURE PROPONENT Executed on y DATE SIGNATURE OF CONTROLLING OFFIC OLDER, 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 Page i Peter Leroe -Munoz for City Council 2014 11327985 • 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)848 -7214 201003589 ADDRESS - CITY STATE ZIP CODE 7597 Monterev 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 NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE). YEAR OF ELECTION PARTY Peter Leroe -Munoz City Council Member 2014 m Nonpartisan I�QQ❑9gT. S L.J ❑ Nonpartisan Primarily formed to support or oppose specific candidateslor measures in a single election. List below: CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) (INCLUDE DISTRICT NO.; CITY OR COUNTY, AS APPLICABLE) CHECK ONE FPP.CForm 410 (Dec /2012) FPPC Advice ::advice@fppc.ca gov (866 /275 -3772) www.fppc.ca:gov :SUPPORT OPPOSE I�QQ❑9gT. S L.J pp❑ In p5E FPP.CForm 410 (Dec /2012) FPPC Advice ::advice@fppc.ca gov (866 /275 -3772) www.fppc.ca:gov