410 Amendment (1) tatement of Organization
Recipient Committee
Statement Type ^ initial
Not yet qualified ® or
-J~
Date qualified as committee
type or print in ink
® Amendment
List I.D. number:
# 1320352
-~_~
Date qualified as committee
(If applicable)
^ Termination -See Part 5
List I.D. number:
~~~~ ~
AUG 2 0 2009
STATEMENT OF ORGANIZATION
~~ UPEPTINO CITY(
Date of Termination C ERK
1. Committee Information
NAME OF COMMITTEE
Marty Miller for Council 2009
STREETADDRESS (NO P.O. BOX)
20348 Clay Street
CITY STATE ZIP CODE AREA CODE/PHONE
Cupertino CA 95014 408/253-1168
MAILING ADDRESS (IF DIFFERENT)
OPTIONAL: FAX / E-MAIL ADDRESS
marty@voteformartymiller.com
COUNTY OF DOMICILE I COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE
Santa Clara
Attach additional information on appropriately labeled continuation sheets.
2. Treasurer and Other Principal Officers
NAME OF TREASURER
Claudette T. Miller
STREET ADDRESS (NO P.O. BOX)
20348 Clay Street
CITY STATE ZIP CODE AREA CODE/PHONE
Cupertino CA 95014 408/253-1168
NAME OF ASSISTANT TREASURER, IF ANY
STREETADDRESS (NO P.O. BOX)
Cli Y J IAI t LIF' GUUt AKtA GUUt/F'HUNt
NAME OF PRINCIPAL OFFICER(S)
STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODElPHONE
3. Verification
I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under penalty of
perjury under the laws of the State of California that the foregoing is true and correct. [~ yJ/
Executed on f~~yo /~9 S By ~' ~!~'~ ~
Executed on~~~~ By
DATE
Executed on
DATE
Executed on
DATE
By
FPPC Forn 410 (June/09)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
By
I NATURE F NTR LL N FFI EHULDER, ANDIDATE. R STATE MEASURE PR P NENT
tatement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Marty Miller for Council 2009
4. Type Of COmmittee Complete the applicable sections.
STATEMENT OF ORGANIZATION
Page 2
1320352
• 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.
ELECTIVE OFFICE SOUGHT OR HELD
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
Marty Miller
City Council of Cupertino
2009 ® Non-Partisan
I
I
1 ^ 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, N.A.
ADDRESS
AREA CODE/PHONE
408/366-2671
BANKAGGOUNI
8123969894
STATE ZIP CODE
10260 South De Anza Blvd. Cupertino CA 95014
Primariy 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
FPPC Form 410 (June/09)
FPPC Toll-Free Helpline: 1366/ASK-FPPC (866/275-3772)
Statement of Organization STATEMENT OF ORGANIZATION
Recipient Committee ~ - ~ ~ ~
INSTRUCTIONS ON REVERSE
Page 3
Marty Miller for Council 2009 11320352
4. Type of Committee (Continued)
Not formed to support or oppose specific candidates or measures in a single election. Check ony one box:
^X CITY Committee ^ COUNTY Committee ^ STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
List additional sponsors on an attachment.
rvAmt ~r ~rvrv~vK
GROUP OR AFFILIATION OF SPONSOR
NU. ANU S I Fitt 1 clrr STATE ZIP CODE
_J~
Date qualified
5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that all of the fdlovdng condftions 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 (June/08)
FPPC Toll-Free Helpline: 866/ASK-FPPC (868/275-3772)