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Cat Tucker - Form 410 - 2016 Amendment (2)Statepent of Organization Recipient Committee Statement Type ❑ Initial Not yet qualified U or ® Amendment List I.D. number: 1298566 Date qualified as committee Date qualified as committee (IYaPPROIae) FOR CITY COUNCIL 2016 Termination – See Part 5 List I.D. number: /___/ Date of Termination STREET ADDRESS (NO P0. BOX) MAILING ADDRESS (IF FAX / E-MAIL ADDRESS Santa Date Stamp REICEIVED AND FILED In 01 otflce of the Secretary of State d Q1e State of Cefifomla JUL 08 2016 official Use Only NAME OF TREASURER Carolyn Tognetti STREET ADDRESS (NO P.O. BOX) NAME OF ASSISTANT TREASURER, IF ANY D. Cat Tucker STREET ADDRESS (NO P0. BOX) NAME OF PRINCIPAL OFFICER(S) STREET ADDRESS (NO P.O. BOX) Attach additional information on appropriately labeled continuation sheets. CITY STATE ZIP CODE 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 California that the foregoing Is true and correct. Executed on /!J � &A-- /6 By DATE 6 Executed on 7-5-1 gy DATE Executed on ey ' 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 Statgrnent of Organization Recipient Committee INSTRUCTIONS ON REVERSE A All committees must list the financial Institution where the campaign bank account Is located. NAME OF FINANCIAL INSTITDTION Union Bank ADDRESS 408 - 848 -2161 Nk]5iT STATE ZIP CODE 1298566 1111 Santa Teresa 1 II e • e �iAuLkslFru:�lidt•Nt; :a+).�i#�- l °" §�'n''1^ iTT�k. i 1}° # .�:. _ 1 .F,��` � ��.,3. rv�bT t�'f 3' F� -.. r f- _ yYg{ Controlle[I;CmnnutTee ^,;1 -� • 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. A 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 Denise Cathy "Cat" Tucker Gilroy City Council 2016 Nonpartisan ® ❑ Nonpartisan Primarily formed to support or oppose specific candidates or measures in a single election. List below: CAN DIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATES) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) FPPC Form 410 ()an /2016) FPPC Advice: sdviceQfppc.Ta.gov (866/275 -3772) www.fppc.ca.gov ` 51) PORT V OPPOSE SUE Li OPP I El FPPC Form 410 ()an /2016) FPPC Advice: sdviceQfppc.Ta.gov (866/275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee Statement Type ❑ Initial ® Amendment List I.D. number: Not yet qualified (j or 1298566 � -' - ✓ -- IF Date qualified as committee Date qualified as committee (If applicable) 1. Committee Information Cdi"YUCKEtt FOR CITY COUNCIL 2016 ❑ Termination — See Part S List I.D. number: 6 Date of Termination STREET ADDRESS (NO P.O. BOX) MAILING ADDRESS (IF DIFFERENT) FAX / E -MAIL ADDRESS Santa Clara Attach additional information on appropriately labeled continuation sheets. 2. Treasurer and Otl NAME OF TREASURER Carolyn Tognetti rs For Official Use Only STREET ADDRESS (NO P.O. BOX) NAME OF ASSISTANT TREASURER, IF ANY D. Cat Tucker STREET ADDRESS (NO P.O. BOX) NAME OF PRINCIPAL OFFICER(S) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE 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 Executed on (per 3�i �� By DATE % r `� Executed on ___ / �J By DATE Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on DATE By 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 CITY COUNCIL 2016 • 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 1408-848-2161 ADDRESS CITY STATE ZIP CODE 8000 Santa Teresa Blvd. Gilroy CA 95020 4. Type of Committee Complete the applicable sections. Page 2 I.D. NUMBER 1298566 • 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 Denise Cathy "Cat" Tucker Gilroy City Council 2016 0 Nonpartisan ❑ Nonpartisan Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) NAME OR MEASURE(S) FULLTtTLE (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 T OPPOSE FPPC Form 410 (Jan /2016) FPPC Advice: advice@fppc.ca.gov (866/275 -3772) www.fpPC.ca.gov