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410 Termination Statement of Organization Recipient Committee STATEMENT OF ORGANIZATION --1--1_ Date qualified as committee --1--1_ Date qualified as committee (II applicable) # 1278918 ~-1!LJ 2006 Date of Termination Date Stamp 'tYpe or print In Ink Statement Type o Initial Not yet qualified 0 or o Amendment List 1.0. number: oa Termination - See Part 5 List 1.0. number: # AUG 2 4 2006 Elect Jeanne Bradford 2. Treasurer and Other Principal Officers NAME OF TREASURER Edward Grant STREET ADDRESS AREA CODE/PHONE STREET ADDRESS r--~~ ZIP CODE "l ~. ~ NAME AND POSITION OF OTHER PRINCIPAl:OFFICER(S), IF APPLICABLE AREA CODE/PHONE CITY OPTIONAL: FAX I E-MAIL ADDRESS COUNTY OF DOMICilE COUNTY 'M-tERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICilE MAILING ADDRESS Santa Clara 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 t~- I certify under penalty of Executed on By SIGNATURE OF CONTROLLING OFACEHOlDER, CANOIDATE, OR STATE MEASURE PROPONENT DATE By Executed on Executed on DATE By Executed on By SIGNATURE OF CONTROlliNG OFFICEHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT DATE FPPC Form 410 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Statement of Organization Redpient Committee STATEMENT OF ORGANIZATION INSTRUCTIONS ON REVERSE CALIFORNIA 41 0 FORM COMMITTEE NAME Elect Jeanne Bradford 1.0. NUMBER 1278918 4. Type of Committee Complete the applicable sections, 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 "non-partisan." . If this committee acts jointly with another controlled committee, list the name and identification number of the other contrOlled committee. NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY rn Non-Partisan Jeanne Bradford City Council 2005 o Non-Partisan . List the financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION AREA CODElPHONE BANK ACCOUNT NUMBER Cupertino National Bank ADDRESS ( STATE ZIP CODE 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 I ,"WUU 10-' SUPPORT OPPOSE FPPC Form 410 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Statement of Organization Recipient Committee STATEMENT OF ORGANIZATION INSTRUCTIONS ON REVERSE CALIFORNIA 41 0 FORM COMMITTEE NAME d 4. Type of Committee (Continued) I.D. NUMBER 1278918 General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box: o CITY Committee 0 COUNTY Committee 0 STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY 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 Small Contributor Committee o ---1---1_ 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 ination 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. FPPC Form 410 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)