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410 Statement of Organization Recipient Committee - Amendment Reassign for 2016 (Stamped by SOS)Statement of Organization Recipient Committee Date Stainp Statement Type El Initial Amendment ❑ Termination - See Part 5 FILE—D Not yetquAifind ❑ or Ust I.D. number: Ust I.D. number: i 1 the office of the Secretary of S fffifi ia S 1 nl #1368800 of the State of California _­ 07 30 2014 # MAR 0 9 2015 VIAR 3 0 2015 Date qualified as committee Date qualified as committee (If appllcaGlei . Date ofTermInation CUPERTINO CITY CLER .!. ! ;;i.77 . : ;.. "'T NAPA E OF COMMITTEE . ....... ........... Dr. Huang for City council 2016 NAME OF TREASURER .... ...... STREET" Isabel Rodriguez NO P.O. BOX) TREASURE I,, IF ANY FAXI E-MAIL ADDRESS ( DrAn•yHuang@gmaii.com STREETADDRESS (NO P.O. BOX) COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS.ACTIVE CIVY Santa Clara Cupertino STATE ZIP CODE AREA CODE/PHONE NAME OF PRINCIPAL OFFICER(S) Attach additional information on appropriately labeled continuation sheets. STREET ADDRESS (No P.O. Box) CITY STATE ZIP CODE AREA CODE/PHONE . . . . . . . . . . . . X.: X". I have used all reasonable diligence in preparing this statement and t"o the best of my knowledge the information con'ta"ined herein is true and complet' c ;ertify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on 03/06/2015 By 0 AT F. DATE ------- SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on DATE By SIGNATURE OPCONTROLLING Or F ICEHOLDER, CAN DI DATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, ORSTATE MEASURE PROPONENT FPPC Form 410 (Dec/2012) FPPC Advice: adv1ce@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON (REVERSE COMMITTEE NAME Dr. Huang for City Council 2016 o All committees midst list the financial institution where the campaign (bank account is located. NAME OF FINANCIAL INSTITUTION ADDRESS :::.. }.............. :....... .. CITY BANK ACCOUNT NUMBER STATE ZIP CODE Page 2 I.D. NUMBER 1368800 • 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. a 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 Off CANDIDATE /OPFICEHOLDEiR /STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY Andy Huang City Council 2016 ❑ Nonpartisan SU PPC)RT ❑ Nonpartisan Primarily formed to support or oppose specific candidates or measures in a single electilon, List: below: CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE.. BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S)1URISDICTION (INCLUDE QISTRTCT NO.. CITY OR COUNTY, AS APPLICABLE) CHECK nNE FPPC Form 414 (Dec /2012) FPPC Advice adviee@fppc.ca.gov (8661275 -3772) wwv. fppc.ca.gov SUPPORT OPPOSE SU PPC)RT ',/0 FPPC Form 414 (Dec /2012) FPPC Advice adviee@fppc.ca.gov (8661275 -3772) wwv. fppc.ca.gov