410 Statement of Organization Recipient Committee – AmendmentStatement of Organization
Recipient Committee
Statement Type ❑ Initial
Not yet qualified ❑ or
II
Date quairrfied as committee
1. Committee Information
NAME OF COMMITTEE
CUPERTINO CHAMBER OF COMMERCE PAC
STREET ADDRESS (NO P.O. BOX)
[�] , Amendment
List I.D. number.
# 1299673
Date qualified as committee
(If applicable)
❑ Termination —See Part
List I.D. number.
CITY STATE ZIPCODE AREACODEIPHONE
MAILING ADDRESS (IF DIFFERENT)
FAX I E-MAIL ADDRESS
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
SANTA CLARA I CITY OF CO2ERTINO
Attach additional information on appropriately labeled continuation sheets.
I_ I
Date of Termination
Date Stamp
I ,
IJ
� i=E31 2018
I
l -LR i 9N 0 ICY GI FI
For Official Use Only
2. Treasurer and Other Principal !O IcfF ers --
NAME OF TREASURER
ANDREW WALTERS
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANTTREASURER, IF ANY
JAMES SUTTON
STREET ADDRESS (NO P_O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF PRINCIPAL OFFICER(S)
RICHARD ABDALAH
STREETADDRESS (NO P.O. SOX)
CITY STATE ZIP CODE AREACODEIPHONE
3. Verification
1 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 and 77rt�he I fw,�s of the State of California
Executed on
DATE
Executed On
DATE
Executed on
DATE
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SIGN,VURE OF CONTROLLING OFFICEHOLDER, CANDIOXE, OR STATE MEASURE PROPONENT
RY SIGNATURE OF CONTRCLUNG OFFICEHOLDER, CANAIORi OR STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 440 (Jan/2016)
FPPC Advice: advice@fppc_ca.gov (8661275-3772)
www.fppc,ca.gov
Statement of Organization
Recipient Committee GALIF&XIIIAFORM 411
INSTRUCTIONS ON REVERSE
Page 2 of 3
COMMITTEE NAME E.D. NUMBER
CUPERTTNO CaAMZR OF COMMERCE PAC 1299673
. All com m iffees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE (PHONE BANK ACCOUNT NUMBER
BANK OF THE WEST {
AODRSSS CITY STATE ZIP CODE
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_"
• if 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 CANDIDATEIOFFICEHOLDEPJSTATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IFAPPLICABLE) YEAR OF ELECTION PARTY
❑ Nonpartisan
❑ Nonpartisan
Primarily formed to support or oppose specific candidates ormeasures inasingle election- list below.
CANDIDATE{5} NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CAND[DATE(S) OFFICE SOUGHT0R HELD OR MEASURE(S) JURISDICTION
(I NCLUDE D I STRI CT N O., C ITY OR COUNTY, AS APL€CABLE) CHECK ONE
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OPPOSE
FPPC Form 410 (Jan12016)
FPPC Advice. advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
` ' &111A
41 j
FORM
INSTRUCTIONS ON REVERSE j
Page 3 of 3
COMMITTEE NAME
I.D. NUMBER
CUPERTINO CHAMBER OF COMMERCE PAC
1299673
4. Type of Committee (Continued)
• SMOR • It It 4 Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
x❑ CITYCommittee ❑ COUN1YCommittee ❑ STATECommittee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
I
TO SUPPORT LOCAL AND STATEWIDE CANDIDATES AND BALLOT MEASURES
I
• . List additional sponsors on an attachment.
NAME OF SPONSOR
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
"CUPERTINO CHAMBEa OF COMMERCE
!
STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE
• . . • ❑
date qualified
I
S.Termination Requirements By signing the verification, the treasurer, assistanttreasurerand/or candidate, officeholder, or proponent certify that all ofthe 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;
i
• 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 Gi vemment Code Sections 89511 -
89518, and are subject to Flections Code Section 18680 and FPPC Regulation 18521.5.
FPPC Form 410 (Jan/2016)
www.netrile.corn FPPC Advice: advice@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov