HomeMy WebLinkAboutForm 410 - 2010 Initial- Statement of Organization T STATEMENT OF ORGANIZATION
Recipient Committee ype or print in ink Date Stamp
Statement Type ® initial
Not yet qualified ® or
Date qualified as committee
❑ Amendment
List I.D. number:
�J— I
Date qualified as committee
(If applicable)
❑ Termination — See Part 5
List I.D. number:
I
Date of Termination
1, Committee Information 2,
NAME OF COMMITTEE
Committee to Elect Woodward Mayor 2012
STREETADDRESS (NO P.O. BOX)
7241 Eagle Ridge Dr.
CITY
STATE ZIP CODE AREA CODE/PHONE
Gilroy CA 95020 408- 891 -9204
MAILING ADDRESS (IF DIFFERENT)
OPTIONAL: FAX/ E- MAILADDRESS
pwoodward@terra-law.com
COUNTY WHERE COMMITTEE IS ACTIVE IF
THAN COUNTY OF DOMICILE
Santa Clara
Attach additional information on appropriately labeled continuation sheets.
r
1
wry
and Other Principal Officers
NAME OF TREASURER
Mark W. Good
bIREETADDRESS (NO P.O. BOX)
750 Lepa Court
CITY
STATE
ZIP CODE
AREA CODE/PHONE
Gilroy
CA
95020
408 - 842 -9033
NAME OF ASSISTANT TREASURER, IF ANY
Perry J. Woodward
STREET ADDRESS (NO P.O, BOX)
7241 Eagle Ridge Dr.
CITY
STATE
ZIP CODE
AREACODE /PHONE
Gilroy
CA
95020
408 -891 -9204
NAME OF PRINCIPAL OFFICER(S)
STREETADDRESS (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 t nfo ati In ntained 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 December 5, 2010 By 1Y
121 DATE f / SIGNATURE OF TREASURER OR ASSISTANT TREASURER
Executed on Q1 O By (�Z,
DATE
Executed on
DATE
Executed on
DATE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (June /09)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275.3772)
'Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Committee to Elect Woodward for Mayor 2012
4. Type of Committee Complete the applicable sections.
STATEMENT OF ORGANIZATION
Page 2
• 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.
NAME OFCANDIDATE /OFFICEHOLDERlSTATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
Perry James Woodward
Mayor
2012
❑ Non - Partisan
❑ Non - Partisan
• List the financial institution where the campaign bank account is located (controlled "candidate election" committees only)
NAME OF FINANCIAL INSTITUTION
ADDRESS
CITY
NUMBER
STATE ZIP CODE
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
FPPC Form 410 (June /09)
FPPC Toil -Free Heipline: 866 /ASK -FPPC (866/275 -3772)
d.
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
r,n,, mittaa tn Flart Woodward for Mayor 2012
4. Type of Committee (Continued)
W. 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
NAME OF SPONSOR
EET
List additional sponsors on an attachment.
O. AND
CITY
INDUSTRY GROUP OR AFFILIATION OF SPUNSuk
STATEMENT OF ORGANIZATION
Date qualified
5. Termination Requirements 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.
-- Leftover funds d 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 (June /09)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)