Daniel Harney - Form 410 Amendment #2 Statement of Organization DateStamp �'
CALIFORNIA 41 0
Recipient Committee FORM
Statement Type RE�+'E�° For Official Use Only
❑Initial ® Amendment ❑ Termination—See Part 5 la, '
0 Not yet qualified 2018 j
or I D 1 CLERK'S OffICE �'
0 Date qualified as committee / / °%/ C,ILROY,,CA
Date qualified as committee Date of termination „A
I (If amending to provide this date)
LP' -7 Or iN. ..dol
1. Committee Information I.D. Number(i�applica��leJ 2. Treasurer and Other Prin •. - ' cers
1386442
NAME OF COMMITTEE NAME OF TREASURER
Harney for Council 2018 Joan Lewis
STREET ADDRESS(NO P.O.BOX)
STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE
Gilroy Ca 95020
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY
Gilroy Ca 95020
MAILING ADDRESS(IF DIFFERENT)
STREET ADDRESS(NO P.O.BOX)
1
E-MAIL ADDRESS(REQUIRED)/FAX(OPTIONAL)
CITY STATE ZIP CODE AREA CODE/PHONE
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S)
Santa Clara Gilroy Daniel Harney
STREET ADDRESS(NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
Gilroy Ca 95020
3. Veri *cation
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 /r.,----)c) By
CANDIDATE,OR STATE MEASURE Pt OPONENT
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 P(OPONENT
FPPC Form 410(May/2017)
FPPC Advice:advice @fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
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Statement of Or anization
9 .4CA:LIFORN'IA
Recipient Committee ;FORM
INSTRUCTIONS ON REVERSE .
Page 2
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COMMITTEE NAME I.D.NUMBER
Harney For Council 2018 1,386442
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• 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 408 842-8200 201004322
ADDRESS CITY STATE ZIP CODE
7597 Monterey Road Gilroy Ca 95020
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Controlled•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."
C 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
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NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
® Nonpartisan
Daniel Harney Gilroy City council 2018
❑ Nonpartisan
'Primarily Formed 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) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION
(INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
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FPPC Form 410(May/2017)
FPPC Advice:advice @fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
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Statement of Organization • ✓CALIFORN'IAI
Recipient Committee :' 'FORM �'
INSTRUCTIONS ON REVERSE •
Page 3
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COMMITTEE NAME I.D.NUMBER
Harney For Council 2018 to 441g,
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General:Purpose.Committee :;j• Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
CITY Committee ❑ COUNTY Committee❑ STATE Committee
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PROVIDE BRIEF DESCRIPTION OF ACTIVITY
Committee to Elect Daniel Harney to Gilroy City Council
Sponsored,Committee 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;:. n-�-� •
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• 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.
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FPPC Form 410(May/2017)
FPPC Advice:adv ice @fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
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