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410 Amendment STATEMENT OF ORGANIZATION Statement of Organization Recipient Committee II o WIlE Date Stamp ~ !E~!E o Tennination - See Part 5 List I.D. number: Type or print in ink 181 Amendment List I.D. number: or D Initial yet qualified o No Statement Type 2006 JAN 3 # ----1----1_ Date of Termination 273991 ----1----1_ Date qualified as committee (If applicable) # ----1----1_ Date qualified as committee RK PERTINO CITY CL C 2. Treasurer and Other Principal Officers NAME OF TREASURER Charles B. Ahern STREET ADDRESS 10371 Miller Ave.. #1 cln Committee Information NAME OF COMMITTEE Advocates for 1 Cupertino a Better AREA CODE/PHONE 821-6414 (408) ZIP CODE 95014 STATE CA Cupertino NAME OF ASSISTANT TREASURER, IF ANY #161 STREET ADDRESS (NO P.O. BOX) 20660 Stevens Creek Blvd cln AREA CODE/PHONE ZIP CODE 95014 STATE CA Cupertino MAILING ADDRESS STREET ADDRESS (IF DIFFERENT) AREA CODE/PHONE ZIP CODe STATE cln E-MAIL ADDRESS FAX OPTIONAL: NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE info@abettercupertino.org COUNTY OF DOMICILE COUNTY WI-IERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE MAILING ADDRESS AREA CODE/PHONE ZIP CODE STATE cln Santa Clara certify under penatty of By Attach additional information on appropriately labeled continuation sheets. Verification I have used all reasonable diligence in preparing this statement and pe~ury under the laws~f the St, of California that the foregoing is ~ Executed on 3 Executed on SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT By DATE Executed on SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 4tO (January/OS) FPPC TolHree Helpline: 866/ASK·FPPC (866/275-3772) By DATE Executed on Statement of Organization Recipient Committee D. NUMBER 1273991 INSTRUCTIONS ON REVERSE COMMITTEE NAME Advocates for a Better Cupertino 4. Type of Committee Complete the applicable sections. List the name of each controlling officeholder, candidate, or state measure proponent. district number, if any, and the year of the election. List the political Ithis controlled, also list the elective office sought or held, and candidate or officeholder II · party with which each officeholder or candidate is affiliated or check "non-partisan. committee acts jointly with another controlled committee, · · controlled committee. list the name and identification number of the other NAME OF CANDIDATE/OFFICEHOLDER/STATI committees only) . I ate election BANK ACCOUNT NUMBER ZIP CODE STATE AREA CODE/PHONE cln NAME OF FINANCIAL INSTITUTION ADDRESS measures in a single election. List below: Primarily formed to support or oppose specific candidates or IINC I 1··~~1~ SUPPORT OPPOSE CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE FPPC Form 410 (January/OS) FPPC Tol~Free Helpline: 866/ASK·FPPC (866/275-3772) STATEMENT OF ORGANIZATION Statement of Organization Recipient Committee .0. NUMBER 1273991 INSTRUCTIONS ON REVERSE COMMITTEE NAME Advocates for a Better Cupertino Check only one box: (Continued) Not formed to support or oppose specific candidates or measures in a single election. 181 CITY Committee 0 COUNTY Committee 0 STATE Committee 4. Type of Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY To participate in general political. legislative, and governmental activities in Cupertino, including future ballot measures and other campaigns. List additional sponsors on an attachment NDUSTRY GROUP OR AFFILIATION OF SPONSOR NAME OF SPONSOR f the committee qualified as a ZIP CODe contributor committee. STATE Check box and provide the dale this committee qualified as a small small contributor committee on January 1,2001, enter 1/1/01. cln NO. AND STREET 0----1----1_ Date qualified STREET ADDRESS By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that all of the following conditions have been met: 5. Termination Requirements 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 to discharge all debts, loans received, and other obligations; intention or ability and This committee has no surplus funds; This committee has filed all Refer to FPPC Form 410 (January/OS) FPPC Tol~F..e Helpline: 8661ASK-FPPC (866/275-3772) 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. Government Code Section 89519. campaign statements