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410 Statement of Organization Recipient Committee - Amendment Stamped by SOSStatement of Organization Recipient Committee Statement Type ❑ Initial 0 Not yet qualified or 0 Date qualified as committee NAME OF COMMITTEE Better Cupertino Action Committee ® Amendment 03 1 27 1 2017 Date qualified as committee (If amending to provide this date) ❑ Termination — See tart 5 STREET ADDRESS (NO P.U. BOX) CITY STATE ZIP CODE AREACODE/PHONE MAILING ADDRESS (IF DIFFERENT) E-MAILADDRE5S (REQUIRED) / FAX (OPTIONAL) COUNTY OF DOMICILE I ]URISDICTION WHERE COMMITTEE 15 ACTIVE Date of t�iion OF TREASURER Xiaowen Wang Date Stamp ECENt i the office of the Secretary of of the State of California JUIN 16 2017 JUN 2 8 2017 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE NAME OF PRINCIPAL OFFICER(5) Xiangchen Xu STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE Attach additional information on appropriately labeled continuation sheets. I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and com penalty of perjury / under the laws of the State of California that the foregoing is true and correct. Executed on 6 / 12— f 7-V l I By DATE MEASURE PROPONENT _ Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (May/2017) FPPC Advice: advice&ppc ca.Sov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER Better Cupertino Action Committee 11395411 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION ADDRESS C1Ty BANK ACCOUNT NUMBER STATE ZIP CODE fu5 ., .,, � S. c o +c .R ,. �' � i3'w tr�,16 ,.� ,f� 1 ' in, . •r� �•, Ni".�.�i. ..: +. ...... .f al �. A,,... „�.. .. , �R ti '}ti� �,'. ,� ;, :iso p " T{���Of.COmm.:Iltteea Camp fetedtlL-.1e F1 I.I1i1 ij�G'4�,is$. �11Y kk 6, i ��. cih�'q: °S�a{, { °1_fRff%Wi;�Il,a!',1$�� /A, List .F • 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 OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IFAPPLICABLE) YEAR OF ELECTION PARTY Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) NAME OR MEASURM) FULLTITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURES) JURISDICTI 0N (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLEI CHECK e]Wr FPPC Form 410 (May/2017) FPPC Advice: advice@fppc-ca.gov (866/275-3772) wwnw.fppc.ca.gov SUPPORT DPPOSE SUPPORT OPPOSE FPPC Form 410 (May/2017) FPPC Advice: advice@fppc-ca.gov (866/275-3772) wwnw.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME Better Cupertino Action Committee 11395411 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 OFACfIVITY List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO, AND STREET CITY STATE ZIP CODE AREA CODE/PHONE Small Contributor Cam ittee Date qualified/ ._... �., � a.. , �. ,. ..,.v - ,�. ... ..,,. .. dr .. � .. .; „ -,�x.. .. ,• 5 � �i,.;r- r, � �., ,�..:-i ...� 4' �L:-dl Y..4.-Iv."i ;-1} I ery " la: ,� k 4 - kl v th, GUI. W e cBx WR kas t4f,7. Ml`:YIIT4dn'�k uvE+.�, .Pi. Ig3� I1 i. I...L �R3•. ..r;fi1V1'!1£d_ ti�.11. r, .. ,y �u r' "m'' "� "1 "' "SII"6 "''� v a�f'n Ch a�u r assfstanttreasre>a�nr cantlPdat�:nFfasehnitle:o:: ra on'entce.. thatall'ofthefolP'o�nrin condliTonshave4beenmet " I}.'.r'.• 5 Trrnlnalinn`Re Ltll'@I]1@115, g,,B.yslgIn hphT eI nn, e,, d : tlg� 1 „,p rt[?� 4 B r, „u,i��.�.iold,la:�-..ownFrwa.:+?�,.:,,.a•sw�a�,ryer�wls,�.a:•��v,�+,.,.�t�,;�t;n..Vl;,r_.,,.h�rs�„Yiw�w7aeu�H�,�r�i�r:ibusa���iaxayrS[asilti+I:�1x[ors:�;5ko:uMl,rvni�D^'�m+atla�zan�ivuLJ:i�,-rrsaaJr,;u�:danri+�sY+�kn�l;t.:.�v�t-0w.c:uau,:�:ti�:u„�u.�s,a_.�nuc�.wl:.t..,v���;nv...Fn re..u�-.ou'.,�_u°nrs.r:.....:.".: .r ..•.1..,. _, , • 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. 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 (May/2017) FPPC Advice: advice@fppc,ca.gov (966/275-3772) www.fppc.ca.gov