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410 Termination Friends Statement of Organization Recipient Committee ST IlrEMENT OF ORGANIZATION Typeorprlnllnlnk o.teStemp Statement Type 0 Initial Not yet qualified 0 Of 0 Amendment List 1.0. number: 00 Tenn_on - See Pari 5 List I.D. runber: fE[;IE~WI # # 851028 ¿_L~-1 ~ Date of Termination JUL 2 1 2004 ----1----1- Date qualified as c.ommittee ----1---1- Date qualified as c.ommittee (11_1 J.fUPERTINO CITY C~ 2. Treasurer and Other Principal Officers 1. Committee Infonnation NAME OF COMMITTEE NAME OF TREASURER Ed Hoffman Friends of Dolores Sandoval STREET ADDRESS 10720 Alderbrook Lane STREET ADDRESS (NO 00. BOX) S1Þ.TE ZIP CODE AREA CODEIPHONE 10720 Alderbrook Lane CI1Y S1Þ.TE ZIP CODE AREA CODE/PHONE CI1Y Cupertino NAME OF ASSISTANT TREASURER, IF ANY CA 95014 4081725-8939 Cupertino MAILING ADDRESS (IF DIFFERENT) CA 95014 4081725-8939 STREET ADDRESS STATE ZIP CODE AREA COOEIPHONE CITY DP11ONAL: FAX I E-MAIL ADDRESS NAME ANO POSITION OF OTHER PRINCI""- OFACER(S), IF APPLICABLE COUNTY OF DOMICilE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICilE MAILING ADDRESS CI1Y S1Þ.TE ZIP CODE AREA CODE/PHONE Attach additional In_ion on appropttataly laba/ad continuation sheats. 3. Verification I have used BII reasonable diligence in preparing this statement and to the best of my is true and complete. I certify under penalty of pe~ury under the laws of the State of California that the foregoing Is tNe and colTee!. Executed on July 21, 2004 DAn; Executed on July 21, 2004 DATE Executed on OATE Executed on DATE B{ B{ B{ SIGNIO'URE OF CDNTROWNG OFFICEHOlDER, CAND""'E. OR STAlE MEASURE F'R<:JPONENT B{ SIGWlURE OF CDNTROWNG OFFICEHCJlD£R. CAND"KE, OR STAlE MEASURE PRCPONENT FPPC FDIm 410 (JanlO3) FPPC TofI.Fra. Halutlne: 886/ASK-FPpC Statement of Organization Recipient Committee STA. , OF. 0RGÞl>I. . . lZ!\'iIlON& CAliFORNIA 41 0 FORM P' og'. 2 INSTRUCTIONS ON REVERSE COMMITTEE NAME 1.0. NUMBER Friends of Dolores Sandoval 851028 4. Type of Committee COmpietetheapplicabiesadions. . List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled, also list the elee!ive office sought orhekl, and distrie! number, if any, Bnd the year ofthe elee!ion. . List the political party with which each officeholder or candidate is affiliated or check "non-partisan." . Ifthis committee ae!s jointly with another controlled committee, list the name and identification number oflhe other controlled committee. NAME OF CANDIDA'EIOFACEHOlDERISTATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABlE) YEAR OF ELECTION PAR TY IRI Non-Partisan Dolores "Dolly" Sandoval Member, Cupertino City Council 2001 DNon-PartIA . List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIAllNSmUTION AREA CODE/PHONE BANK ACCOUNT NUMBER Citibank ADDRESS 800/274-6660 ~ 11326060800 S1Þ.TE ZIP CODE 1303 S. Mary Avenue Sunnyvale CA 90487 . Primarily formed to support Of oppose specific candidates or measu,,", in a single election. List below: CANDIDME(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION -,- - ~ ~~ - ~ - ~ ~ ~ I _"Œ~m=~.=~~~.Œ- ~ FPPC Form 410 (JanlO3) FPPC T~ree Halpftne: 866/ASK-FPPC INSTRUCTIONS ON REVERSE Statement of Organization Recipient Committee COMMITTEE NAME Friends of Dolores Sandoval 4. Type of Committee (Continued) . Not formed to support Of oppose specific candidates or measures in a single election. Check only one box: 0 CITY Committee 0 COUNTYCommltt.. 0 STATECommm.. PROVIDE BRŒF DESCRIPTION OF ACTIVITY Us! additional spon&OfS on an attacI1men!. NAME OF SPONSOR rOUSTRYGROUPOR AFFllL<nONOFSPONSOR STREET ADDRESS NO. AND STREET CITY S1Þ.TE ZIP CODE Small Go,,'n/JU,n¡ GOf""""",, 0 ----1---1- Check box and provide the date this committee qualified as a smaR contributor committee. If the committee qualified as a Date qualified small contributor committee on January 1, 2001, enter 1/1101. 5. T ennination Requirements By signing the verification, thetreasurer, assistant treasurer and/or candidate, ofIiœholder, Of proponBf1t œrtify 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. n There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Govemmen1 Code Section 89519, Refer 10 FPPC Fann 410 (JanlO3) FPPC Tol~F..... Helpline: 866/ASK-FPPC Instructions for Statement of Organization CALIFORNiA 41 0 FORM General Purpose Committee A committee is a general purpose committee if its principal activity is supporting or opposing a variety of candidates or measures not voted upon in a single election. . A city committee makes contributions and expenditures in connection with a single city's elections and includes special districts located within a single city. . A county committee makes contributions and expenditures in connection with a single county's elections. A county committee also includes elections for special districts located in a single county or any number of cities located in a single county. . A state committee makes contributions and expenditures in connection with state electiOrlS, or in connection with elections held in more than one county. Provide a brief description of the committee's political activities such as whether or not it supports candidates or measures that share a common political affifiation. If the general pu¡pose committee meets the sponsored committee definition, also complete the sponsored committee section. Sponsored Committee A "sponsored committee" is a general purpose or primarily fomned committee, other than an officeholder or candidate controlled committee, that has one or more sponsors. An organization, business, or other emity is a sponsor if one or more of the fullowing apply: . The committee receives 80% or more of its contributions from the entity or organizalion or its members, officers, employees, or shareholders, . The entity or organization collects contributions for the committee by use of payroll deductiOrlS or dues from its members, officers or employees. . The entity or organization, alone or in combination with other entities or organizations, provides all or neatly all of the adminisllalive services for the committee. . The entity or organization, alone or in combination with other entities or organizations, sets the policies for contribution solicitations or payment of expenditures from committee funds. See the instructions for Pari 1 for name identification requirements. Small Contributor Committee A "small contributor committee" is one that . Has been in existence for more than six months; . Receives contributions from 100 or more persons; . Makes contributiOrlS to five or more candidates; and . Has not received more than $200 from one person in a calendar year. See FPPC Regulation 18503. 5. Tennination Requirements Recipient committees do not auiomatically telTninate; they may only terminate under the following circumstances: . They have ceased to receive contributions and make expenditures; and . They do not anticipate receiving contributions, repayments of outstanding loans made to others, or any other receipts in the future, and they do not anticipate making expenditures in the future; and . They have eliminated or have no intention or ability to discharge all their debts, loans received, and other obligations; and . They have no campaign funds; and . They have filed aU required campaign statements disclosing all reportable transactions, including disposition of funds. State Candidates: There are specific mandatory termination deadlines applicable to your controlled committees. See FPPC regulation 18404.1. How to Terminate State Recipient Committees . FOe an original and one copy of the Form 410 Statement of Organization Termination along with an original and one copy of your Form 450 or 460 with the Secretary of State. . File two copies of your FOITO 450 or 460 with your local filing officials. Local Recipient Committees . File an original and one copy of the Form 410 Statement of Organization Termination with the Secretary of State; and . File a copy of the Form 410 Statement of Organization Termination, along with an original and one copy of your FOITO 450 or 460 with your filing officer. FPPC FDIm 410 (JanlO3) FPPC Toll-F... Helpline: 8661ASK.FPPC