410 Statement of Organization Recipient Committee - Initial not yet qualifiedRecipient Committee
Statement Type 2 Initial
Not yet qualified W or
Date qualified as committee
171 Amendment
List I.D. number:
Date qualified as committee
(if applicable)
171 Termination — See Part 5
List I.D. number:
Date of Termination
NAME OF COMMITTEE
Committee supporting Cupertino Citizens' 'j15; Grravi-h Ire, -hwfilcz
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Cupertino CA 95014
MAILING ADDRESS (IF DIFFERENT)
Cupertino, CA 9501 5 -1 1 32
FAX / E-MAIL ADDRESS
—IN I y UI- JUMIULt ' URISDICTION WHERE COMMITTEE 15 ACTIVE
Santa Clara Cupertino, CA
1_
IN
Date Stamp
FE 0 V E
1 4. 2015
CUFERTINO CITY CLER
NAME OF TREASURER
Xiaowen Wang
For Official Use Only
STREET ADDRESS (NO PO. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Cupertino CA 9514
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF PRINCIPAL OFFICER(S)
Xiangchen Xu
Attach additional information on appropriately labeled continuation sheets. STREET ADDRESS (NO P.O. BOX)
I have used all reasonable diligence in preparing this statement and t-o-
penalty of perjury under the laws of the State of California that the foi
�-
Executed on 4 By
DATE
Executed on /2' —% 4 ILE By
DATE
CITY STATE ZIP CODE AREA CODE/PHONE
Cupertino CA 95014
of my knowledge the information contained herein is true and complete. I certify under
true and correct.
SIGNATURE OF CONTROLLING OF
R, CANDIDATE, OR STATE MEASURE PROPONENT
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
;;-tatement of Organization CALIFORNIA
Recipient Committee FORM 41 C
INSTRUCTIONS
Page 2
COMMITTEE NAME
Committee supporting Cupertino Citizens' S6,�,Ve I.D. NUMBER
°All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
ADDRESS
mv
°
List the name mf 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.
NAME n,CAmo/omE/oFF/csoomcn/Smrs MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT unHELD
(INCLUDE DISTRICT NUMBER /pAPPLICABLE) YEAR opELECTION p^mY
it * - It - 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 ORmmmRE(S) JumSD/mom
Cupertino Citize
SUPPORT
Z
OPPOSE
El
FPPC Form 410 (Dec/2012)
pPPC Advice: advice@fpmu.ca.gpv(866/Z75-377Z)
Statement of Organization
Recipient Committee
INSTRUCTIONS omREVERSE
COMMITTEE NAME I Page 3
Committee supporting Cupertino Citizens' �en541e ILD. NUMBER
General Purpose Committee Not formed to support or oppose specific candidates or measures ina single election. Check only one box:
OCITYCommittee E]COUNTY Committee[:] STATE Committee
List additional sponsors on an attachment.
NAME OF SPONSOR
- —1-1 ... INU.,IN U,.KLI,.
D.te 71,11
CITY
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
o This committee has ceased to receive contributions and make expenditures;
STATE ZIP CODE
• 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. Refer1o6overnment
Code Section 89519.
- Leftover funds of ballot measure committees maybe used for political, legislative or governmental purposes under Government Code Sections 89511 8951@, and are
subject to Elections Code Section 18680 and FPPC Regulation 18521.5.
FPpCporm 410 (Dec/2012)
*PPC Advice: advice@f pc.ca.gov(V66/a7g-3772)