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460 Amendment 12-31-2009 Recipient Committee Campaign Statement Cover Page (Government Code Sections 84209-94216.5) • SEE INSTRUCTIONS ON REVERSE ~ I5 t{ ~ ~ COVERPAGE Type or print in ink. D Dale Stamp a , ~ 2 ~ ~ ~ '~ ~ ~ . p e ~ of ~_ Statement covers period Date of election If app cable ,7 , ~ ~0/ (Month, Day, Year CU ERTINO CITY ClE Far O~ciel use only from i~~3/-yoo i~9.~& IQJ' through 1. Type of Recipient Committee: Au cnmmrtteea -template Pads ~, 2, a, and 4. Z, Type of Statement: ® Officeholder,CanditlateControlletlCommitlee ^ PdmadlyFormedBallotMeasure ^ PreeleclionStatement ^ quatterlyStatement Q State Candidate Election Cemmiltee Commi9ee l {Semi-annual Statement ^ Special Odd-Year Repad Q Recall Q Controlled ^ 7ennination Statement ^ Supplemental Preelection (AlsoCemplefeParf5) Q Sponsored (Also fie a Form 419 Termination) Statement-Attach Form495 (AlsoCanplefePaA6) ~ Amendment (Explain below) ^ General Purpose Commi9ee Q Sponsored ^ PdmarilyFormedCandidatel ~Nb ~-Zo-aa, ~klN 11~/Y~b~f 70 sM~if sNy~ ~Diace~z°~~ QSmaIlContdbuterCommittee i l Officeholder Committee (NsoComple(ePadl) t' ZT S~~CILD B~; 7N~ I~GCL~C ~~~fl~T~1~ SS i~(CDRRZLT ee l QPolilicalPartylCenttalComm . NuMeER I D ~~ ~k~r~RVt>l~ ~~~ ~RuTH 3. Committee Information . . 951367 Treasurers ~ ~ girt iJ'i~iJ Ssu D -~7,A~.A>J~ rr COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER inl~R Sue-Fay L Chanq BARRY CHANG FOR CUPERTINO SCHOOL BOARD MAILINGADDRE55 STREET ADDRESS ( CITY STATE ZIP CODE AREA COOEIPHONE NAME OF ASSISTANT TREASURER, IF ANY Cupertino CA 95014 MAILINGADDRE55 ( CITY STATE ZIP CODE OPTIONAL: FAX I E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is tme and complete. I certify underpenalty of perjury underlhe laws eithe State of California that the foregoing is tr~° °^~ ^^^°^t Executed an ' ~ ~ ~ ' ZO i D Dale Executed on i~ i 7/~ l O Dale Executed on Dale By By Executed on BY Dale SlgnaNreorConhollingOfficahdder,Candidete,5leleMeesurePmpenenl FPPCForm460(Januaryle5) FPPC Toll•Free HelpBne: afifilASK•FPPC (fififil27fi•97T2i State of California By SignehaenrCanholling Officahdder, Candidala,Stale Measure Pmpmenf