Marie Blankley - Form 410 (2018)Statement of Organization
Recipient Committee
Statement Type ® Initial
Not yet qualified
or
O Date qualified as committee
❑ Amendment
❑ Termination — See Part b
/—/ —W I
Date qualified as committee Date of termination
rn
LVO
NOV -2 2017
For oflichi Use Only
1. Committee information
I.D. Number
��� J:� a
(if applicable)
NAME OF COMMITTEE
NAME OF TREASURER
Marie Blankley for City Council 2018
Paul Vanni
STREET ADDRESS (NO P.O. BOX)
STREET ADDRESS (NO P.O. BOX)
CITY
STATE ZIP CODE
AREA CODE /PHONE
Gilroy
CA 95020
408 - 847 -4330
CITY STATE ZIPCODE AREA CODE /PHONE
NAME OF ASSISTANT TREASURER, IF ANY
Gilroy CA 95020 408 - 842 -4544
Marie Blankley
MAILING ADDRESS (IF DIFFERENT)
STREET ADDRESS (NO P.O. BOX)
E -MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL)
CITY
STATE ZIP CODE
AREA CODE /PHONE
voteblankley @gmail.com
Gilroy
CA 95020
408 - 842 -4544
COUNTY OF DOMICILE
JURISDICTION WHERE COMMITTEE IS ACTIVE
NAME OF PRINCIPAL OFFICER(S)
Santa Clara
Gilroy, CA
STREET ADDRESS (NO P.O. BOX)
Attach additional information on appropriately labeled continuation sheets.
CITY
STATE ZIP CODE
AREA CODE /PHONE
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 pe ` uncie;t -he laws of
MEASURE PROPONENT
Executed on By
DATE
Executed on
DATE
OF CONTROLLING
MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (October /2017)
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 1 D NUMBER
Marie Blankley for City Council 2018
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION I AREA CODE /PHONE BANK ACCOUNT NUMBER
Rabobank 408 - 842 -1938 1140653055
ADDRESS
CITY
STATE ZIP CODE
805 First Street Gilroy CA 95020
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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." Stating "No party preference" is acceptable.
• 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 YEAR OF PARTY
NAME OF CAN MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION
Marie Patane Blankley
Gilroy City Council member
2018
Nonpartisan
Partisan (list political party below)
Nonpartisan
Partisan (list political party below)
Formed rim r 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)
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME
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'(October /2017)
Clear Page Print FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
- - - - www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Marie Blankley for City Council 2018
Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee ❑ Political Party /Central 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
Page 3
STATE ZIP CODE AREA CODE /PHONE
5 °<Terminaifon r;� f� �. =.b s - .�.,�_ F , n ®.
e u cements' a ,si the veilflcatfon the treasurer; ess slant nd% kl ate, officetio)der; on ial orieiit`certf t that ell of ttie foUnwtn coed i=
Q . _.., ��_?� Y gr! _• ,'� 1 treasLrer a h or cari8 a ihotis liav'e tieeii m"
Y.r ,rte< .,.z ..__ .-'0- .��.__N_, —: r -- _-?',._P „�_ �_.
• 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 maybe 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.
Clear Pagel Print_ FPPC Form 410 (October/2017) t FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
Santa Clara Gilroy, CA
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 cent
penalty of pe ` ;r�t��e;t -he laws of
PROPONENT
Executed on By
DATE
Executed on
By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410(October /2017)
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
Marie Blankley for City Council 2018
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
Rabobank
ADDRESS
AREA CODE /PHONE
408 - 842 -1938
CITY
BANK ACCOUNT NUMBER
140653055
STATE ZIP CODE
805 First Street
Gilroy
CA
95020
Partisan (list political party below)
4. iyiw of Comlmi# tee Complete the applicable sect! a z �
Nonpartisan
Partisan (list political party below)
• 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." Stating "No party preference" is acceptable.
• 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 YEAR OF PARTY
NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
Marie Patane Blankley
Gilroy City Council member
2018
Nonpartisan
✓
Partisan (list political party below)
Nonpartisan
Partisan (list political party below)
Formed Primarily Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATES) NAME OR MEASURE(S) FULLTITLE (INCLUDE BALLOT NO. OR LETTER)
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(5) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
OPPOSE
FPPC Form 410 (October /2017)
Clear Page Print FPPC Advice: advice@fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Page 3
I.D. NUMBER
Marie Blankley for City Council 2018
I. Type of Committee (Continued)
• • • Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee ❑ Political Party /Central 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 AREA CODE /PHONE
Small Contributor Committee
Date quaifled
S.TermlttaitionReqvlmments eyslgmng the vofttioo , the trea3uuM "assts rtEtressurerand/"orcandidite,gf oidlder.orPrOP alt certify that aliofthefDOOWk *coodidons have bmnaft
• 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 (October /2017)
Clear Page; Print FPPC Advice: advice@fppc.ca.gov (866 /275 -3772)
www.fppc.ca.gov