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410 Statement of Organization Recipient Committee - Amendment qualified Statement of Organization Date Stamp i+A, ,cnDnilA _ Recipient Committee 0;,,;1 Ito 7 t,¢ • Statement Type ❑Initial Amendment ❑ Termination—See Part 5 For official Use Only Not yet qualified 1.3 or List I.D.number: List I.D.number: n 1365260 # MAY 3 0 2014 ..1 —y_/ 0--/2—✓2014 --/_—/ Date qualified as committee Date qualified as committee Date of Termination CUPERTINO CITY CLERK pf applicable) 2. Treasurer and.Other�Principal Officers !.ttt�e°Inforr�;�ltlgn= ; _ _ 7:7 NAME OF COMMITTEE NAME OF TREASURER Don Sun For Cupertino City Council 2014 Helen Fu STREET ADDRESS INO P.O.BOX) STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE MAILING ADDRESS OF DIFFERENT) NAME OF ASSISTANT TREASURER.IF ANY FAX/E-MAIL ADDRESS STREET ADDRESS(NO P.O.BOX) COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE CITY STATE ZIP CODE AREA CODE/PHONE Santa Clara NAME OF PRINCIPAL OFFICERS) STREET ADDRESS(NO P.O.BOX) Attach additional information on appropriately labeled continuation sheets. CITY STATE ZIP CODE AREA CODE/PHONE r I have used all reasonable diligence in preparing this statement and to the best Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT FPPC Form 410(Dec/2012) FPPC Advice:advice @fppc.ca.gov(866/275-3772) www.fppc.ca.gov Statement of Organization CALIFORNIA 410 Recipient Committee FORM INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I .NUMBER Don Sun For Cupertino City Council 2014 1365260 • All committees must list the financial Institution where the campaign bank account Is located. NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER East West Bank ( ADDRESS CITY STATE ZIP CODE Typt' of Committee;:complete theappticable 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"nonpartisan." • 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 ®Nonpartisan Don Xiao Sun Cupertino City Council 2014 ❑Nonpartisan 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 SUPPORT El n x_ sum DPPOSF • FPPtForj 410(Dec/2012) .€ FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov Statement of Organization CALIFORNIA Recipient Committee FORM 410 INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME 1.0.NUMBER Don Sun For Cupertino City Council 2014 1365260 cntototICOPitlittee (Continued) General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee ❑ COUNTY Committee❑ 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 Date qualified S.:Termination Requirements a q y signing the verification,the treasurer,assistant treasurer and/or candidate,officeholder,or proponent certify that all of the following have been rrret: • 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(Dec/2012) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov