410 Statement of Organization Recipient Committee – AmendmentStatement of Organization
Recipient Committee
Statement Type ❑ Initial
Not yet qualified ❑ or
1.
Datequalified as commit�ee
M Amendment [] Termination —See Part
List 1.0. number: List LD. number.
# 137a937 #
48 j 23 !4015 _�___.]_
Date quatifedascomm0ee Date of Termination
(Sf applifable)
1. Committee Information
NAME OF COMMITTEE .
Barry Chang for Assembly 2016
STREET ADORESS (NO P.O. 80X)
CITY STATE ZTP CODE AREA CODEIPHONE
MAILING ADDRESS (IF DIFFERENY)
FAX F -MAIL ADDRESS
COUNTY OF DOMICILE I
JURISDICTION1ANERE COMMITTEE IS ACTIVE
Santa Clara
F_'0"!cia€Use only
AUG 1 2017 f
C( PERTINO CITY CLE 'K .
2. Treasurer and Other Principal Officers
NAME OF TREASURER
Barry Chang
STTiEET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODEIPHONE
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREACODEIPHONE
NAME OF PRINCIPAL OFFICER(S)
AfCach additional infon-nation on appropriately labeled Continuation sheets. STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREAC00E:IPHONE
3. Verification
I have used all reasonable diligence in preparing this statement and to the best of nay knowledge the information contained herein is true and complete. I certify under
penalty of perjury udder the laws of the State of California that the foregoing/i5 true and correct.
Executed on 7/15/2017 Es
Executed OR 7/18/2017By
.
CATS
Executed on
DATE
w SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE, OR STATE MEASURE PFC)PONENT
FPPG Form 410 (.Ian/2016)
www.netiile.com FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppa.ce.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Barry Chang for Assembly 2016
• All committees must list thefinancial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA COMPHONE BANK ACCOUNT NUMBER
Community Tst Bank {
ADDRESS CITY STATE ZIP CODE
1.378937
4. Type of Committee Complete the applicable sections.
.
• 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."
• It 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 CANDfD4ElOFFICEHOLDERISTATE MEASURE PROPONENT (INCLUDE DISTRICT NUM13ER IF APPLICABLE) YEAR OF ELECTION PARTY
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE{S} NAME DR MEASURES FULL TITLE (INCLUDE BALLOT NO. OR LETTER CANDIDATE(S) OFFICE SOUGHTOR HELD OR MEASURE(S) JURISDICTION
MEASURE(S) ) (INCLUDE DISTRICTNO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE
OPPOSE
FPPC Form 410 (Jan12016)
www.neirrle.com FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
Assembly D%strict 24
❑ Nonpartisan
Barry Chang
2016
Democratic Party
❑ Nonpartisan
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE{S} NAME DR MEASURES FULL TITLE (INCLUDE BALLOT NO. OR LETTER CANDIDATE(S) OFFICE SOUGHTOR HELD OR MEASURE(S) JURISDICTION
MEASURE(S) ) (INCLUDE DISTRICTNO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE
OPPOSE
FPPC Form 410 (Jan12016)
www.neirrle.com FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME f.D. NUMBER
Barry Chang for Assembly 2016 1378937
4. Type of Committee (Continued)
• + + Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTYCornmittee ❑ STATECommittee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
.. . - Listadditional sponsors on.an attachment.
NAME OF SPONSOR
INDUSTRY GROU P OR AFFILIATION OF SPONSOR
STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE
❑ ��
Datequalified
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 t=iled 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 (Jan12016)
www.r� ifle.c m FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov