410 Statement of Organization Recipient Committee - Termination Statement of Organization
Recipient Committee
Statement Type ❑Initial ❑ Amendment
Not yet qualified ❑ or List I.D.number:
#
Date qualified as committee Date qualified as committee
(If applicable)
1. Committee Information
NAME OF COMMITTEE
Kris Wang for City Council 2016
21 Termination—See Part 5
List I.D.number:
#1390787
0_/3_2017
Date of Termination
DtgatJ W 114
FEB - 7 2017
UPERTINC CITY CLEkK
.2. Treasurer and Other Principal Officers
NAME OF TREASURER
Angela Tsai
STREET ADDRESS(NO P.O.BOX)
STREET ADDRESS(NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
MAILING ADDRESS(IF DIFFERENT)
For Official Use Only
FAX/E-MAIL ADDRESS
COUNTY OF DOMICILE
JUn I�U IL I IUN WHERE COMMITTEE 15 ACTIVE
Attach additional information on appropriately labeled continuation sheets.
CITY
STATE
CA
ZIP CODE
95014
AREA CODE/PHONE
(408)931-6186
NAME OF ASSISTANT TREASURER,IF ANY
STREET ADDRESS(NO P.O.BOX)
CITY
STATE
ZIP CODE
AREA CODE/PHONE
NAME OF PRINCIPAL OFFICER(S)
STREET ADDRESS IND P.O.BOX)
CITY
STATE
ZIP CODE
AREACODE/PHONE
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 01/31/2017 By
DATE
OR STATE MEASURE PROPONENT
Executed on By
DATE
Executed on
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
FPPC Form 410(Jan/2016)
FPPC Advice:advice @fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
MMI ME T A
rls fang for City Council 2016
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
Wells Fargo Bank
ADDRESS
AREA CODE/PHONE
(
CITY
BANK ACCOUNT NUMBER
STATE ZIP CODE
Page 2
I.D.NUMBEP,
Y
S'.g�.! �=''O _'L1Y11T.1�I�t£E COnI I�t�e.f�'lE�a (IGa�b'IeeCt10I1St3° w ,.,;-ri'� .'� ::� .. ?'�'F�� r�� ,r .�+•�>C,,fc +� a��.- �i a��. r a ;..�^?l a,?;�s� 3--^-"' �'-�,`.
_
• 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.
NAME OF CAN MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
Kris Wang
Cupertino City Council
2016
Nonpartisan
- -
SUPPORT
❑ 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
FPPC Form 410(Jan/2016)
FPPC Advice:advice @fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
SUPPORT
El
OPPOSE
F1
- -
SUPPORT
OPPOSE
FPPC Form 410(Jan/2016)
FPPC Advice:advice @fppc.ca.gov(866/275-3772)
www.fppc.ca.gov