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410 Initial Statemen of Organization tatement of Organization ~3 Recipient Committee Statement Type ~ Initial Not yet qualified Q or 07 / 11 / 09 Date qualified as committee 1. Committee Information NAME OF COMMITTEE Darcy Paul for Cupertino City Council 2009 Type or print in ink ~ Amendment List I.D. number: Date qualified as committee (If applicable) ~31gb2s ate Stamp ~ Termination -See Part 9~t th office of sj~ ~ccl-Utary List LD. number: Of Etta S:atr ;~< Californi -J-~- Date of Termination JUL 2 2 2009 ~~ ~~E 2. Treasurer and Other Principal Officers STATEMENT OF ORGANIZATION r- For Official Use Only ~~ Li ~L nnr~~ i Z;i'utJ I L i ~'E~?T(~!O CITY CAE K ---~___ STREET ADDRESS (NO P.O. BOX) 20370 Town Center Lane Suite 100 CITY STATE ZIP CODE AREA CODE/PHONE Cupertino CA 95014 (408) 517-0977 MAILING ADDRESS (IF DIFFERENT) OPTIONAL: FAX / E-MAIL ADDRESS exerciseyourdemocracy@g mai Isom COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE Santa Clara Attach additional information on appropriately labeled continuation sheets NAME OF TREASURER Betsy Shoup STREET ADDRESS 440-12 Galleria Drive CITY STATE ZIP CODE AREA CODE/PHONE San Jose CA 95134 (408) 456-0403 NAME OF ASSISTANT TREASURER. IF ANY' STREET ADDRESS CiTr" STATE ZIP CODE AREA CODE/PHONE NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE 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. Executed on July 20, 2009 By DATE Executed on July 20, 2009 ~ DATE Executed on Executed on DATE ~' SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT FPPC Form 410 (Jan/01) FPPC Tnll-Free Halnlinec 8661ASK-FPPC SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT tatement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME I.D. NUMBER Darcy Paul for Cupertino City Council 2009 4. Type of Committee Complete the applicable sections. • 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 CANDIDArE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY Darcy Paul Cupertino City Council 2009 ^Q Non-Partisan Non-Partisan • Listthe financial institution where the campaign bank account is located (controlled "candidate election" committees only) NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER Wells Fargo Bank (408) 725-2311 2222862696 ADDRESS CITY STATE ZIP CODE 20230 Stevens Creek Blvd Suite A Cupertino CA 95014 • . Primarily formed to support or oppose specif c 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 OPPOSE FPPC Form 410 (Jan/01) FPPC Toll-Free Helpline: 866/ASK-FPPC