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410 Statement of Organization Recipient Committee - TerminationStatement of Organization Recipient Committee Statement Type ❑ initial ❑ Amendment #dot yet qualified ❑ or List I.D. number- 4 Date qualified as committee Date qualified as committee pf applkable) ® Termination — See Part 5 List I.D. number: # 1365260 12 /24 /2014 Date ofTermination 1. Committee Information - NAME OF COMMITTEE Don Sun for Cupertino City Council 2014 STREET ADDRESS (NO RO, BOX) MAILING ADDRESS (IF DIFFERENT) FAX / E-MAIL ADDRESS COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE Santa Clara Attach additional information on appropriately labeled continuation sheets. JAN 2015 CUPERTINO CITY CI_ER 2. Treasurer and Other Principal Officers NAME OF TREASURER Helen Fu For OH4ciat Use Only STREET ADDRESS (NO P.O. BOXI STATE. CA ZIP CODE 94043 AREA CODE /PHONE (415)828 -9456 NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO P,D. BOX) CITY STr,TE ZIA VOCE AREA CODE /PHONE NAME OF PRINCIPAL OFFICERIS) STREET ADDRESS iNO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE 3.' I have used all reasonable diligence in preparing this statement and to the PROPONENT Executed an DATE Executed On DATE By SIGNATURE of CONTROLLING OrrICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT By SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE, OR STATE MEASURE PROPONENT FPPCForm 410 (Dec /2012) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER Dan 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 East West Bank ADDRESS AREA CODE /PHONE ( STATE ZIP CODE 4. Type of Committee Complete the applicable sections. • List the name of each controlling officehoider, candidate, or state measure proponent. If candidate or officeholder controlled, also list the elective office sought or meld, 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. NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY Don Xiao Sun Cupertino City Council 2014 0 Nonpartisan SUPT ❑ Nonpartisan ! 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 N0. OR LETTER) CANDIDATES) OFFICE SOUGHT OR HELD OR MEASURES) 1URISWCTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE FPPC Form 410 (Dec /201x) FPPC Advice: advice@fppc.ca.gov (866/275 -3772) www.fppc.ca.gov SUPPORT OPPOSE SUPT jP�PP��S5EE]]] 6E� FPPC Form 410 (Dec /201x) FPPC Advice: advice@fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.p. NUMBER Don Sun for Cupertino City Council 2014 1365260 4. Type :of Committee (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 I- -i UL MKI[Y Ut:,LKIP I ION OF A[TIVITY • List additional sponsors on an attachment. NAME OF SPONSOR GROUP OR AFFILIATION OF SPONSOR - ��.��+ i•v. nirv.11-1 CITY STATE ZIP CO DE Small Contributor Committee ❑ pate qualified 5. Termination Requirements By signing the verification, the treasurer; assistant treasurer and /or candidate, officeholder, or proponent certify that all of the following conditions 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 E= ections 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