410 Termination tatement of Organization
Recipient Committee
Statement Type 0 Initial
Notyetqualified ~ a
_J_J
Date qualified as committee
Type or print in ink
~ Amendment
List I.D. number:
#_-
._J_J
Date qualified as committee
QI applicable)
®Termination -See Part 5
List I.D. number:
# 1319770
2 ~ 5J 10
Date of Termination
1. Committee Information
NAME OF COMMITTEE
Orrin Mahoney for Council - 2009
STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREACODEIPHONE
Cupertino CA 95014
MAILING ADDRESS (IF DIFFERENT)
COUNTY OF
Santa Clara
COUNTY OF DOMICILE
ISACTIVE IF DIFFERENT
Attach additional information on appropriately laheled continuation sheets.
oate
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f`EB 11 X10
CIUPERTINO CITY
2. Treasurer and Other Principal Officers
STATEMENT OF ORGANIZATION
NAME OF TREASURER
ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREACODEIPHONE
Cupertino CA 95014
NAME OF ASSISTANT TREASURER, IF ANY
STREETADDRESS (NO P.o. BOX)
rm STATE ZIPCODE AREACODEIPHONE
NAME OF PRINCIPAL OFFICER(S)
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREACODEIPHONE
3. Verification
I have used all reasonable diligence in preparing this statement and to the best of knowledge the information contained herein is true and complete.
perjury under the laws of the State of California that the foregoing is true ar
Executed on 21812010 By
Executed on 21812010 gy
DATE
Executed on
DATE
Executed on
DATE
I certify under penalty of
By
SIGNATURE OF CONTROLLING OFFICEHOLDE ,CAN IDA R STATE EA UR PROPONEN
FPPC Form 410 (June109)
FPPC Toll•Free Helpline: 9661ASK-FPPC (8661275.3712)
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
tatement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
STATEMENT OF ORGANIZATION
Page 2
Orrin Mahoney for Council - 2009
4. Type Of COIYI1TIIttee Complete the applicable sections.
1319770
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 CANDIDATEIOFFICEHOLDERISTATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IFAPPLICABLE) YEAR OF ELECTION PARTY
Orrin Mahoney
Cupertino City Council
2009 ® Non-Partisan
Non-Partisan
• List the financial institution where the campaign bank account is located (controlled "candidate election" committees only)
NAME OF FINANCIAL INSTITUTION
Wells Fargo Bank
Cupertino CA 95014
• ~ i ~ ~ Primarily formed to support or oppose specifc candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE(S) FULLTITLE (INCLUDE BALLOT NO.OR LETTER)
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, ASAPPLICABLE) CHECK ONE
FPPC Form 410 tJune109)
FPPC Toll-Free Helpline; 8651ASK•FPPC (8661275.3772)
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Orrin Mahoney for Council - 2009
4. Type of Committee (Continued)
' ~ ~ ~ Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
QCITY Committee Q COUNTY Committee Q STATE Committee
STATEMENT OF ORGANIZATION
1319770
PROVIDE BRIEF DESCRIPTION OFACTIVITY
~ ~ r I • ~ ~ List additional sponsors on an attachment.
nnm~vrarvnaun
STREETADDRESS NO.
GROUP OR AFFILIATION OF SPONSOR
ZIP
i ~~ ~
~~_J
Date qualified
5. Temllnatl0n RegUlrementS By signing the verification, the treasurer, assistant treasurer andlor candidate, officeholder, or proponent certify that all of the following condfiions 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 of 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 (June109)
FPPC Toll-Free Helpline; 8661ASK•FPPC (8661275.3772)