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410 Statement of Organization Recipient Committee - Amendment TerminationStatement of Organization Recipient Committee Statement Type ❑ Initial ❑x Amendment List I.D. number. Not yet qualified [:1or # 1383796 f L 03 1 _0.3 I 2016 Date qualified as committee Date qualified as committee (If applicable) ❑x Termination — See Part 5 List I.D. number. # 1383796 0� 031 2017 Date of Termination 1. Committee Information NAME OF COMMITTEE NO ON C AND YES ON D - CUPERTINO NEIGHBORS, RnUCATORS, AND THE CUPERTINO CHAMBER OF COMMERCE FOR THE SENSIELE AND SUSTAINABLE REVITALIZATION OF VAI,LCO, (SEE ATTACHMENT FOR COMPLETE COMMITTEE NAME) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE MAILING ADDRESS (IF DIFFERENT) FAX 1 E-MAIL ADDRESS COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE ISACTIVE MARIN CITY OF CUPERTINO t! AY 1 6 2017 PERTINO CITY 2. Treasurer and Other Principal Officers NAME OF TREASURER SEAN P. WELCH STREET ADDRESS (NO P.Q. BOX) CITY For Official Use Only STATE ZIP CODE AREA CODEIPHONE NAME OF ASSISTANTTREASURER, IFANY HILARY J. GIBSON STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE NAME OF PRINCIPAL OFFICER(S) REED MOULDS Attach additional information on appropfiately/ labeled Continuation Sheets. STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODEIPHONE 3. Verification I have used all reasonable diligence in preparing this Executed On DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on Ey DATE SIGNATURE OF CONTROLL€NG OFFICEHOLDER, CANDID)WE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (Jan/2016) www.netfile.com FPPC Advice: advice@fppc.ca.gov (866I275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME I I.D. NUMBER NO ON C AND YES ON D - CUPERTINO NEIGHBORS, EDUCATORS, AND TEE CUPERTINO CHAMBER OF COMMERCE FOR THE SENSIBLE AND SUSTAINABLE REVITALIZATION OF VALLCO, (SEE ATTACHMENT FOR COMPLETE COMMITTEE NAME) 1383796 • All committees must Iistthe financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODEIPHONE BANK ACCOUNT NUMBER BANK OF MARIN { ADDRESS CITY $TATE ZIP CODE 4. Type of Colmlmitkee 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 parry 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 CANDIDVE/OFFICEHOLDERISTATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IFAPPLICABLE) YEAR OF ELECTION _ PARTY 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 SOUGHTOR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICTNO., CITY OR COUNTY, ASAPPLICABLE) CHECK ONE SUPPORT OPPOSE MEASURE ➢ CITY OF CDPERTiNO X MEASURE C CITY OF CUPERTINO OPPOSE X www.nele.com FPPC Form 410 (Jan12016) FPPCAdvice: advicela'?"fppo.ca.gov (13661275-3772) www.fppe.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 3 of 4 COMMITTEE NAME I.D. NUMBER NO ON C AND YES ON D - CUPERTINO NEIGHBORS, EDUCATORS, AND THE CTPERTINO CHAMBER OF COMMERCE FOR THE SENSIBLE AND SUSTAINABLI 1383796 REVITALIZATION OF VALLCO, (SEE ATTACHMENT FOR COMPLETE COMMITTEE NAME) 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 ❑ COUNFYCommittee ❑ STATECommittee PROVIDE BRIEF DESCRIPTION OF ACTIVITY • List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR SAND HILL PROPERTY COMPANY AND VALLCO PROPERTY OWNER LLC DEVELOPMENT STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE Date qualified 5. Termination Requirements Bysigning theverification, thetreasurer, assistant treasurer and/or candidate, officeholder, or proponent certify that all ofthefollowing 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 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 (Jan/2016) www.nefle-corn FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppaca.gov Additional Comments For Form 410 ADDITIONAL COMMENTS Page 4 of 4 COMMITTEE NAME NO ON C AND YES ON D - CUPERTINO NEIGHBORS, EDUCATORS, AND THE CUPERTINO CHAMBER OF COMMERCE FOR THE SENSIBLE I.D. NUMBER AND SUSTAINABLE REVITALIZATION OF VALLCO, (SEE ATTACHMENT FCR COMPLETE COMMITTEE NAME) 1383796 ADDITIONAL ADDRESS: COMPLETE COMMITTEE NAME - NO ON C AND YES ON D - CUPERTINO NEIGHBORS, EDUCATORS, AND THE CUPERTINO CHAMBER OF COMMERCE FOR THE SENSIBLE AND SUSTAINABLE REVITALIZATION OF VALLCO, WITH MAJOR FUNDING BY SAND HILI, PROPERTY COMPANY AND VALLCO PROPERTY OWNER LLC www.netfile.com