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Home My WebLink AboutAl Pinheiro - Form 410 - Termination 2012Statement of Organization Recipient Committee Statement Type ❑ Initial Not yet qualified ❑ or Date qualified as committee 1. Committee Information Type or print in ink ❑ Amendment List I.D. number: -J� Date qualified as committee (If applicable) E] Termination — See Part 5 List I.D. number: # 1255866 12 / 31 12012 Date of Termination NAME OF COMMITTEE COMMITTEE TO ELECT AL PINHEIRO STREETADDRESS (NO P.O. BOX) 190 FIRST STREET CITY STATE ZIP CODE AREA CODE /PHONE GILROY CA 95020 408 - 842 -4619 MAILING ADDRESS (IF DIFFERENT) OPTIONAL: FAX/ E -MAIL ADDRESS COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE SANTA CLARA N/A Attach additional information on appropriately labeled continuation sheets Date Stamp bid JAN 2�3 CLERKS C 2. Treasurer and Other Principal Officers STATEMENT OF ORGANIZATION For Official Use Only NAME OF TREASURER MARIE P. BLANKLEY STREET ADDRESS 2290 CORAL BELL COURT CITY STATE ZIP CODE AREA CODE/PHONE GILROY CA 95020 408 - 842 -4544 NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE MAILING ADDRESS 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 llaaws of the State of California that the foregoing is true and correct. Executed on 1 By DATE --- -� ,� SIGNATURE OF TREASURER OR ASSISTANT TREASURER Executed on _ /1��J�..� BYL� L!'✓ DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER CANDIDATE OR STATE MEASURE PROPONENT Executed on DATE RC _ By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT 1 P)r FPPC Form 410 (January/05) /' ��.J/ FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE TO ELECT AL PINHEIRO 4. Type of Committee Complete the applicable sections. "calaral Zemm rwaorew 1255866 • 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 "non- partisan." • 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 NAME OF CAN MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY AL PINHEIRO MAYOR, CITY OF GILROY 2007 ❑ Non - Partisan ❑ Non - Partisan • List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANKACCOUNT NUMBER SANTA BARBARA BANK & TRUST 888 - 400 -7228 10103835880 ADDRESS CITY STATE ZIP CODE 8000 SANTA TERESA BLVD GILROY CA 95020 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) CHECKONE SUPPORT IOPPOSE SUPPORT I OPPOSE FPPC Form 410 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Statement of Organization Recipient Committee STATEMENT OF INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D. NUMBER COMMITTEE TO ELECT AL PINHEIRO 1255866 4. Type of Committee (Continued) General 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 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 ❑ —J� Check box and provide the date this committee qualified as a small contributor committee. If the committee qualified as a Date qualified small contributor committee on January 1, 2001, enter 1/1/01. 5. Term i nation Requ i rementS By signing the verification, the treasurer, assistant treasurer and /or candidate, officeholder, or proponent certify that all of the following conditions have been met: • 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. FPPC Form 410 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772) Statement of Organization Recipient Committee Statement Type ❑ Initial Not yet qualified ❑ or Date qualified as committee 1. Committee Information NAME OF COMMITTEE COMMITTEE TO ELECT AL PINHEIRO Type or print in ink ❑ Amendment List I.D. number: Date qualified as committee (If applicable) in ® Termination — See Part 5 List I.D. number: # 1255866 12 / 31 / 2012 Date of Termination STREET ADDRESS (NO P.O. BOX) 190 FIRST STREET CITY STATE ZIP CODE AREA CODE /PHONE GILROY CA 95020 408 - 842 -4619 MAILING ADDRESS (IF DIFFERENT) OPTIONAL: FAX /E -MAIL ADDRESS COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT NAMEAND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE THAN COUNTY OF DOMICILE SANTA CLARA N/A Attach additional information on appropriately labeled continuation sheets Date Stam CE17VEU FILEI office State of Calif rn a Sty JAN 17 2013 DEBRAe, BOWEN secretary of State STATEMENT OF ORGANIZATION For Official Use Only 2. Treasurer and Other Principal Officers NAME OF TREASURER MARIE P. BLANKLEY STREET ADDRESS 2290 CORAL BELL COURT CITY STATE ZIP CODE GILROY CA 95020 AREA CODE/PHONE 408 - 842 -4544 NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE NAMEAND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE 3. Verification 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 By DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER 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 Executed on By nATF SIGNATURE OF CONTROLLING OFFICEHOLDER CANDIDATE OR STATE MEASURE PROPONENT C(OPY FPPC Form 410 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE STATEMENT OF ORGANIZATION COMMITTEE NAME I.D. NUMBER COMMITTEE TO ELECT AL PINHEIRO 11255866 4. Type of Committee Complete the applicable sections. • 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 "non- partisan." • 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 NAME OF CANDIDATE /OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY AL PINHEIRO MAYOR, CITY OF GILROY 2007 ❑ Non - Partisan ❑ Non - Partisan • List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER SANTA BARBARA BANK & TRUST 888 - 400 -7228 10103835880 ADDRESS CITY STATE ZIP CODE 8000 SANTA TERESA BLVD GILROY CA 95020 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 IOPPOSE SUPPORT I OPPOSE FPPC Form 410 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee •' FORM 410 INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D. NUMBER COMMITTEE TO ELECT AL PINHEIRO 11255866 4. 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 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 ❑ �� Check box and provide the date this committee qualified as a small contributor committee. If the committee qualified as a Date qualified small contributor committee on January 1, 2001, enter 1/1/01. 5. Term i nation Requi rementS By signing the verification, the treasurer, assistant treasurer and /or candidate, officeholder, or proponent certify that all of the following conditions have been met: • 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. FPPC Form 410 (January/05) FPPC Toll -Free Helpline: 866 1ASK -FPPC (8661275 -3772) Statement of Organization Recipient Committee Statement Type ❑ Initial Not yet qualified ❑ or Date qualified as committee i IPl�i.l �11111►�1��a 1110] ruf:tt full Type or print in ink ❑ Amendment List I.D. number: —J —J Date qualified as committee (If applicable) R] Termination — See Part 44 List I.D. number: 1n # 1255866 12 ► 31 ► 2012 Date of Termination NAME OF COMMITTEE COMMITTEE TO ELECT AL PINHEIRO STREET ADDRESS (NO P.O. BOX) 190 FIRST STREET CITY STATE ZIP CODE AREA CODE /PHONE GILROY CA 95020 408 - 842 -4619 MAILING ADDRESS (IF DIFFERENT) OPTIONAL: FAX/ E -MAIL ADDRESS COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE SANTA CLARA N/A Date the JPN � � 3p13 p cret� 0 STATEMENT OF ORGANIZATION For Official Use Only 2. Treasurer and Other Principal Officers NAME OF TREASURER MARIE P. BLANKLEY STREET ADDRESS 2290 CORAL BELL COURT CITY STATE ZIP CODE AREA CODE /PHONE GILROY CA 95020 408 - 842 -4544 NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE Attach additional information on appropriately labeled continuation sheets. 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 of California that the foregoing is true and correct. Executed on ds• 0-7 p By Z�u/ � DATE SIGNATURE OF TREAS RER OR ASSISTANT TREASURER Executed on ° e b: 3 By C— DATE SIGNATURE OF CONTROLLING 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 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)