410 Statement of Organization Recipient Committee - Amendment (2)Statement of Organization
Recipient Committee
Statement Type ❑ Initial
Q Not yet qualified
or
O Date qualified as committee
NAME OF COMM ITTEE
Better Cupertino Action Committee
® Amendment
03 1 27 / 2017
Date qualified as committee
(If amending to provide this date)
❑ Termination — See Part 5
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
MAILING ADDRESS (IF DIFFERENT)
E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL)
COUNTY OF DOMICILE I JURISDICTION WHERE COMMITTEE 15 ACTIVE
I--1
Date of terming 'on
NAME OF TREASURER
Xiaowen Wang
STREET ADDRESS (NO P.O. BOX)
ECD atWE
JUL 2 4 2017
PERTINC CITY CLERK
For Official Use Only
CITY STATE ZIP CODE AREA CODE/PHONE
-
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF PRINCIPAL OFFICER(5)
Xiangchen Xu
STREET ADDRESS (NO P.O. BOX)
18691 Newsom Ave
CITY STATE ZIP CODE AREACODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
Cupertino
CA 95014 650-260-5951
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
CAND IDATE. OR STATE M FASURE PRO PON ENT
Executed on
DATE
By
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 (May12017)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIAi
i
Recipient Committee • -
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D. NUMBER
Better Cupertino Action Committee 1395411
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
ADDRESS
CITY
BANKACCUUNT NUMBER
STATE ZIP CODE
.. Y p pp , tions
4. T e:of Committee Com: tete the a lii:able sec - ,
• 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 CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT
ELECTIVE OFFICESOUGHTOR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION
PARTY
PrimarilyPrimarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE(S) FULLTITLE (INCLUDE BALLOT NO. OR LETTER)
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(5) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
FPPC Form 410 (May/2017)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
SUPPORT
OPPOSE
SUPPORT
❑
OPPOSE
❑
FPPC Form 410 (May/2017)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 3
COMMITTEE NAME 1.0. NUMBER
Better Cupertino Action Committee 1395411
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 ❑ COUNTY Committee ❑ STATE Committee
PROVIDE BRIEF DESCRIPTION OFACTIVITY
List additional sponsors on an attachment.
NAME OF SPONSOR
GROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE AREACODE/PHONE
Small Contributor Committee 1
❑ ��
Date qualified
5. Termination -Requirements'By signing the verificarion; the treasu►er; assistant treasuref'and/or candidate; offlceholde'r or proponent certify that all of the following cdndit of ns 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. Referto 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 18G80 and FPPC Regulation 18521.5.
FPPC Form 410 (May/2017)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
uvmrw fppc.ca.gov