Gilroy Citizens Opposing Measure F - Form 410 - TerminationStatement of Organization
Recipient Committee
Statement Type ❑ Initial
Not yet qualified ❑ or
10 101 12014
Date qualified as committee
NAME OF COMMITTEE
Gilroy Citizens Opposing Measure F
❑ Amendment
List I.D. number:
# 1372023
Date qualified as committee
(If appkable)
❑ Termination — See Part 5
List I.D. number:
#1372023
SO
1_� 3_� 2015
Date of Termination
STREET ADDRESS (NO P.O. BOX)
MAILING ADDRESS (IF DIFFERENT)
NAME OF TREASURER
Harvev Blodaett
For Official Use Only
STREET ADDRESS (NO PO. BOX)
CITY STATE ZIPCODE AREA CODE /PHONE
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
FAX /E -MAIL ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE 15 ACTIVE NAME OF PRINCIPAL OFFICER(S)
Santa Clara Gilroy
STREET ADDRESS (NO P.O. BOX)
Attach additional information on appropriately labeled continuation sheets. CITY STATE ZIPCODE AREA CODE /PHONE
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 TREASURER OR ASSISTANT TREASURER
. �,6Executed on By
DATE
SIG 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 (Jan /2016)
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
Gilroy Citizens Opposing Measure F ., 11372023
• All committees must list the financial institution where the campaign bank account is located.
NAML OF FINANCIAL INSTITUTION AREACODE/PHONE BANK ACCOUNT NUMBER
Pinnacle Bank 1(408)842-8200
ADDRESS CITY STATE ZIPCODE
7597 Monterey Gilroy • 1
1 �SeJ3 til r -1' by%aa ? cc� i , rj�:te 7 n t
[Controlledi Committee
• 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 APPLICARI FI YEAR OF ELECTION PA2TV
Primarily 'Formed Committee I Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATES) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER)
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
IINCLUDE DISTRICT NO rlTv nR rnl INTV ec APPI IrIkRI c1
City of Gilroy Safety & Quality of Life Measure F
City of Gilroy
CHECK
SUPPORT
ONE
OPPOSE
-
sufPQRT
OPPOSE
FPPC Form 410,(Jan /2016)
FPPC Advice: advice @fppc ca.gov�(866 %275 - 3772)
www.fppc.ca:gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Page 3
COMMITTEE NAME _
I.D. NUMBER
Gilroy Citizens Opposing Measure F 1372023
Purpose� Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee
..Mt ur SPONSOR
List additional sponsors on an attachment.
OR AFFILIATION OF SPONSOR
NU.ANU bl Kttl CITY STATE ZIPCODE
Small Contributor E� I
• This committee has ceased +to receive contributions and make expenditures;
• This committee does not anticipate receiving contributions or makingexpenditures 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 may be 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 (Jan /2016)
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
10 1 101 2014
Date qualified as committee
NAME OF COMMITTEE
Gilroy Citizens Opposing Measure F
❑ Amendment
List I.D. number:
#1372023
Date qualified mittee
(If applicable)
❑ Termination — see Part 5
List I.D. number:
#1372023
1�3�2015
Date of Termination
STREET ADDRESS (NO P.O. BOX)
MAILING ADDRESS (IF DIFFERENT)
FAX / E -MAIL ADDRESS
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
Santa Clara Gilroy
NAME OF TREASURER
Date Stamp
R CEIVED ARID FIL
In t 1a office of the Secretary of i
of the State of Caliiomia
JAN 28 2016
Harvev Blodaett
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 OFFICERS)
STREET ADDRESS (NO P.O. BOX)
Attach additional information on. a CITY STATE ZIP CODE AREA CODE /PHONE
f appropriately labeled continuation sheets.
I
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 Ca�tregoing is true and correct.
Executed on t4 /Zc�((o By All
D TE SIGN RE OF TREASURER OR ASSISTANT TREASURER
Executed on By
DATE SIGNATURE OF CO ROLLING 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 (Jan /2016)
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
Gilroy Citizens Opposing Measure F ® 1372023
• 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 1(408)842-8200
ADDRESS CITY STATE ZIP CODE
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 OWHELD .
NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE)' YEAR OF ELECTION PARTY
rimari 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 OWHELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
City of Gilroy Safety & Quality of Life Measure F
City of Gilroy
SUPPORT
❑
OPPOSE
❑✓
_
SUPPORT
OpPOSF
FPPC Form 410,(Jan/2016)
FPPC Advice: advice @fpprca.gov (866 /275 -3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME - - -
J1I.D. UMB ER
Gilroy Citizens Opposing Measure F N
1372023 3
• 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
STREET
NU. ANU 5FREE7
Sm.I Contributor Committee .
CITY
• This committee has ceased to receive contributions and make expenditures;
GROUP OR AFFILIATION OF SPONSOR
STATE ZIPCODE
• 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 may be 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 (Jan /2016)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov