Committee for Measure F Quality of Life - Form 410 TerminationStatement of Organization
Recipient Committee
Statement Type ❑ Initial ❑ Amendment 0 Termination — See Part 5
Not yet quaBfied ❑ or List I:D. number. Listl.D. number:
u #1370490
If 12 .131 .12014
Date qualified,as committee Date qualified as committee Date of Termination
(If applicable)
NAME OFCOMMITTEE
Committee for Measure F, Quality of Life
STREET ADDRESS (NO P.O. BOX)
MAILING ADDRESS (IF DIFFERENT)
Gilroy, CA 95020
FAX / E -MAIL ADDRESS
COUNTY OF DOMICILE JURISDICTION. W HERE COMMITTEE IS ACTIVE
Santa Clara
Attach additional information on appropriately labeled continuation sheets.
Date Stamp
For official Use Only
in t ie ,t secretary i�
a S
JAN 0 2 2015
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)
STREET ADDRESS (NO P.O. BOX)
CITY
I have used all reasonable diligence:in',preparing this statement and to the best of my knowledge
penalty of perjury under the laws of the State of California that the foregoing is true.and correct.
Executed on 112/31 1201.4 By
DATE %
Executed on %j d 1 — 2d Lr By
DATE
STATE ZIP CODE AREA CODE/PHONE
true an
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
under
Executed,on By
DATE - SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (Dec/2012)
FPPC Advice: advice@fppc.ca.govs(866 /275 -3772)
www.fppc ;ca.gov
• All committees must list the financial institution where the campaign bank accountis located.
NAME OF FINANCIAL INSTITUTION AREA CODE /PHONE BANK ACCOUNT NUMBER
Pinnacle Bank 1(408)762-7171 1201002854
ADDRESS CITY STATE ZIP CODE
7597 Monterey Street Gilroy CA 95020
4 Type OfiCOmmittee Complete the applIcablepsections _.
• 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.
NALAC nc rANnInATF /nFFIrFHnI nFR /STATEMEASURE PROPONENT
:ELECTIVE. OFFICE SOUGHT ORMELD
.(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(S1.NAME;OR MEASURE(S) FULL TITLE '(INCLUDE BALLOT NO.ORSLETTER)
CANDIDATEW OFFICE. SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(imn iim THSTRICT-NO;. CITY'OR COUNTY, . AS APPLICABLE)
CHECK ONE
Committee for Measure F Quality& Life
Gilroy
SUPPORT
❑✓
OPPOSE
❑
bUEEMT
OPPOC,.
F.PPC Form,410 ?(Dec /2012)
�FPPC Advice: advice@fppc.ta.govi(866 /275 -3772)
www,fppc ca.gov,
Statement of Organization
Recipient Committee
Statement Type ❑ Initial
Not yet qualified ❑ or
Date qualified as committee
NAME OF COMMITTEE
❑ Amendment
List I.D. number:
# 1370490
Date qualified as committee
(Rapplicable)
Committee for Measure F, Quality of Life
® Termination - See Part 5
List I.D. number:
#1370490
13_72014
Date of Termination
STREET ADDRESS (NO P.O. BOX)
MAILING ADDRESS (IF DIFFERENT)
7937 Hanna Street, Gilroy, CA 95020
FAX/ E -MAIL ADDRESS
COUNTY OF DOMICILE I IU RISOICTION WHERE COMMITTEE 15 ACTIVE
Santa Clara
Attach additional information on appropriately labeled continuation sheets.
Date Stamp
I
DEC 2014
�7 1' CLEW''
NAME OF TREASURER
Sara Humphrey -Nino
For Official Use Only
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)
STREET ADDRESS (NO P.O. BOX)
CITY
STATE ZIP CODE AREA CODE /PHONE
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„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.
Executed on 12/31/2014 By
PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
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
Sfatement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME LD NUMBER
Committee for Measure F, Quality of Life 1'370490
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
Pinnacle Bank
ADDRESS
AREA CODEIPHONE
(408)762 -7171
CITY
BANKACCOUNT
201002854
STATE ZIP CODE
7597 Monterey Street Gilroy CA 95020
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 "nonpartisan"
• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
NAME OF CAN MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION
PARTY
PrimarilyTormed Committee 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)
CANDIDATEW OFFICE SOUGHT OR HELD OR MEASURES) JURISDICTION
(INCLUDE' DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
Committee for Measure F Quality of Life
Gilroy
SUPPORT
0
OPPOSE
El
SU
�T
O
PPOSE
FPPC Form 410 (Dec /2012)
FPPC Advice: advice @fppc.ca.gov (866 /275 -3772)
www.fppc.ca.gov