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Gilroy Growing Smarter - Form 410
Statement of Organization Recipient Committee Statement Type © Initial ❑ Amendment ❑ Termination — See Part 5 Not yet qualified ❑ or List I.D. number: List I.D. number: a # 02 , 081 2016 Date qualified as committee Date qualified as committee Date of Termination (If applicable) 1. Committee Information 2. Treasurer ai NAME OF COMMITTEE NAME OF TREASURER Gilroy Growing Smarter STREET ADDRESS (NO P.O. BOX) 7690 Santa Theresa Drive CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 (650)575 -8285 MAILING ADDRESS (IF DIFFERENT) FAX / E- MAILADDRESS COUNTY OF DOMICILE IURISDICTION WHERE COMMITTEE 15 ACTIVE Santa Clara Gilroy, California Date Stamp r Principal Phillip Roloff STREET ADDRESS (NO P.O. BOX) CITY For Official Use Only STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 ( NAME OF ASSISTANT TREASURER, IF ANY Emily May McEwan- Upright STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 ( NAME OF PRINCIPAL OFFICER(S) Constance Rogers STREET ADDRESS (NO P.O. BOX) Attach additional information on appropriately labeled continuation sheets. CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 ( 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 MEASURE PROPONENT Executed on By DATE SIGNATURE OFCONTROLLING 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 A ®- Recipient Committee ®- INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER Gilrov Growina Smarter - All committees must list the financial institution where thetampaign bank account is located. NAME OF FINANCIAL INSTITUTION Union Bank ADDRESS AREA CODE /PHONE (408)846 -1236 CITY BANK ACCOUNT NUMBER 0062599519 STATE ZIP CODE 8000 Santa Teresa Boulevard Gilroy CA 95020 4zType `o# CoMmittee complete the applicable sections f .._ �_.�� -.. - «� ............. .� ,.�... ___ _._.....:,.. _. ._�. _..mot._.__ r,. _... _. ... _ ._. _ _ .. � ... .,. , k t jk:'•'t - 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 • 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 MEASURES) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) Gilroy Urban Growth Boundary Initiative (preliminary narrl@ Gilroy, California SUPPORT Q OPPOSE ❑ Sin O 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 Gilrov Growina Smarter Continued) Page 3 I.D. NUMBER 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 ADDRESS NO. AND STREET Date qualified CITY GROUP OR AFFILIATION OF SPONSOR STATE ZIP CODE P S Terirninafion Re Uir...emelnt5 fay: ;lgmng the verificati om the, treasurer ,assistant treasures and or candidate; ofHceholtler or r "o 'onent ce ; a.' q :... ...... ... . . ... ..:. ....._ .... ,,�: _: >. -:.: .._. ,.,. _ >. _...__n!fYthat` all:: ofthefollowingcondltions�haveibeen7t ,- ;.t.Y „, • 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 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 0 Rtb P* Statement of Organization Recipient Committee Statement Type © Initial Not yet qualified ❑ or 008 /2016 Date qualified as committee ❑ Amendment List I.D. number: Date qualified as committee (If applicable) 1. Committee I�fQrmation „ E NAME OF COMMITTE Gilroy Growing Smarter ❑ Termination — See Part 5 List I.D. number: # Date of Termination STREET ADDRESS (NO P.O. BOX) 7690 Santa Theresa Drive CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 (650)575 -8285 MAILING ADDRESS (IF DIFFERENT) FAX / E -MAIL ADDRESS gilroygrowingsmarter @gmail.com COUNTY OF DOMICILE IURISD ICTION WHERE COMMITTEE IS ACTIVE Santa Clara Gilroy, California Date Stamp FE81`, 2016 2. Treasurer and Other Principal Officers NAME Of TREASURER Phillip Roloff STREET ADDRESS (NO P.O. BOX) For Official Use Only CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 ( NAME OF ASSISTANT TREASURER, IF ANY Emily May McEwan- Upright STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 ( NAME OF PRINCIPAL OFFICER(S) Constance Rogers STREET ADDRESS (NO P.O. BOX) Attach additional information on appropriately labeled continuation sheets. CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 ( 3. Verification I have used all reasonable diligence in preparing this statement and to the best f my knowledge the information contained herein is true and complete. I certify under penalty of perjury under the laws of the 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 A 6 . Recipient Committee moo . L, WI INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME LD - . NUMBER - Gilrov Growina Smarter .. • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE /PHONE BANK ACCOUNT NUMBER Union Bank 1(408)846-1236 10062599519 ADDRESS STATE ZIP CODE 8000 Santa Teresa Boulevard Gilroy CA 95020 ��.: V,: ;l,i j21it'•iy�ra ,ll bid SE1- .,�; Lj f t �'; !. 't. y ,.y. t .:*J.. ' WTI �A +d �.�,�`.*�:.. N.A:.c...°�S..AKrrwu"?.� I I I 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. e List the political party with which each officeholder or candidate is affiliated or check "nonpartisan." e 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 I 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 ONE Gilroy Urban Growth Boundary Initiative (preliminary narrId, Gilroy, California SUPPORT Q OPPOSE SU-PPONT OPPOSE FPPC Form 410 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Statement of Organization 0=, Recipient Committee ®. INSTRUCTIONS ON REVERSE Page COMMITTEE NAME I.D. NUMBER Gilroy Growinq Smarter 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 a List additional sponsors on an attachment. NAME OF SPONSOR - JINDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET. ADDRESS NO. AND STREET CITY STATE :ZIP CODE a a a ❑ Date qualified - - - :_%'.3 r �.., -:.t: $a:.; - ,:iY '�-: ._ .. "fi= ..4�t -,.: •, tYr T ..< . - ;.: "t . ,f -... 5: 5. S;.Terlriitioq a iwli ekher>I� g sl non xtie,�riHtid gBUrer' liEtatt<tY�'au(` =a%ii dlc�n a = i ...0 Y . _... 3S / did tt+,� 0l • rc# .o .n cent : tN t ` f�Nfelle. lit ;df7 itioti4e. arl ^nlc. Y • 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 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 COPY Statement of Organization Recipient Committee Statement Type © Initial Not yet qualified ❑ or � -, 7z--,` �6 -5 3 �' � ; ❑ Amendment ❑ Termination — See Part 5 List I.D. number: List I.D. number: 02 /08 12016 ( / Date qualified as committee Date qualified as committee (If applicable) L, Cgfmmitt00�t!'rft�rtirattaii " NAME OF COMMITTEE Gilroy Growing Smarter Date of Termination STREET ADDRESS (NO P.O. BOX) 7690 Santa Theresa Drive CITY STATE ZIP CODE AREA CODE /PHONE Gilroy CA 95020 (650)575 -8285 MAILING ADDRESS (IF DIFFERENT) FAX / E-MAIL ADDRESS gilroygrowingsmarter @gmail.com IUKIl UlI:I11 WHt1 LOMMI ITEE IS ACTIVE Santa Clara Gilroy, CaIifornia Attach additional information on appropriately labeled continuation sheets. I have used all reasonable diligence in preparing this statement and to the penalty of perjury under the laws of the 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 complete. I certify under FPPC Form 410 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee 1 INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER Gilrov Growina Smarter _ • All committees must list the financial institution where,the campaigrr bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE /PHONE BANK ACCOUNT NUMBER Union Bank 1(408)846-1236 0062599519 ADDRESS CITY STATE ZIP CODE 8000 Santa Teresa Boulevard 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 NAME -OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT DISTRICT SOUGHT OR HELD N (INCLUDE DISTRRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATES) NAME OR MEASURES) FULL TITLE (INCLUDEBALLOT NO: OR LETTER) CANDIDATE MEASURE (S) OFFICE SOUGHT OR HELD OR MEASURS) JURISDICTION ilNrl (Inc nICTCfrT- 117 1I.,.... e.nm.- Gilroy Urban Growth Boundary Initiative (preliminary narre Gilroy, California L.MK SUPPORT 0 U IVt OPPOSE El SUHUILT l O� FPPC Form 41&(Jan/2016) FPPC Advice: advice @fppc.ce.gov(866 /275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D. NUMBER Gilroy Growing Smarter .. 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 STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE Date qualified Tz e�WWO ; r @, , .. 1at�S '. t � `d � z :-.�r.i � :," ,6 r: y 1 , s i 8►.I ,i.� : .;.t.. h e y�rlhfl.e ... ,t. to !�? .:e t .. ya �.>t4r� e!s�;,r _s-u.. . �r`e..�.r .: , _�eJa•.. s � .�ls.tua. ` , (.!_;_ir.,[ _R , e r a - s ° � F r- i . =�I �u,rt ,,� d x / �G .v j S li � �a'�ad. , , i d t Ate aa y o-.f. � �h�. l�����- f�prodon�nEceriliyf . t hat�Iilbftk�foifbWingcdriaittoFsi • 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 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