410 Statement of Organization Recipient Committee - Amendment 12-20-18 Stamped by SOS 12-3-18 ��n�
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Statee�aent af Qrgar�ezati�n � i 0 � / DateStamp � ; � ;��
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!. Committee information 2 Treasurer and Other Principal O#Ficers ��"� �� L� � �f � �
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NAMEQFCOMMITfE� .� .. NAM�aF TRFASURfft � 'u ����
Cupertino Pol'�ical Reforms r AC Xiangehen Xu �i��� � � , L ,-; ,,,�< ��� �
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SLREET ADDRESS(NO P.O.60X}
fUCL MAIqNG ADDRE55(1F DkFPERET7f} STREEE ADQRESS{�O P.O.BOXj
COtIPlTY 6F DOMICFLE lUR3SDiCTION WHERE C6MMITTEE IS ACFIVE NAME IIfi PRINGPAL OFf10ER(5)
Xiar3gehen Xu
STREET ADDR£55{NO P.O.B6Xj
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3, Ver�caiion'
i have used afl r�asanable di#igenee in pre,�aring this statement and to the best af rny knowledge the information eontained her2in is true and camplete. 1 certify uncEer
pena3ty o#perjury under the iavus a#the State cf California
MEASUBf PROPONEAfT
EXECUCeCI OR B�
DATE SIGNRTURE QF CONTRQtLING OFPtCEHOtAER,LAN➢IDkTE,QR STAFE MEASURE PROPQNENT
Executed on gy
DAT� S16NATURE OF tONTROLll1dG OFRCEHOLDER,CANDtllNE,Oft SFATE MEASU RE PRt1PONENF
FPPC fort�t 410(Augustf20YS}
EPPC Advice:advice@fppc.ca.gov(866Iz753372j
www.fppc.ca.gov
S�a#er�ent of t3rgar�izati�n . � - .
� 'Fte�i�ient Cor�mittee � _ � �
' lNSTRttt710NS ON REVERSf
Page 2
COMM}17EE NAME
�c I.D.N{1MBER
�'itlj3�1�99�10�O�t�ICcZ��{@BOC6fIS�RV
• J;IE cocascnittees crsast iist the 45nancia!i,��stitution where the caenpaign bar�k account is iocated.
NAME OF£INANC�AtfNSfl'FtiTi6N RREACODE/PHONE BANKACCDUNTNUMBER
ADDRSS QF! SfATE Z4PtODE
_..
�.Type of Commi$ee Complete the applicable sections.
_. _ __ _ . _ _ _ _
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s List the name of each controiiing officel�o}der,candicPate,or state measure proponent_ [f candidate cn ci##aceholc�er controfled,atso list the eieetive of�ce sought or held,and
district number,if any,and the year of the election.
• Lisk the politiea!party wi�h which eaeh t�fficehalder ar eandidate is a#�r#iated or cneck"n��artisarr:' Stating"No party preferance"is acceptab(e.
• 1f this comrrtitYee acts joint{y w"s#h another contro9{ed com►nittee,iist the name and identifi�ation nutvtbe�-o�the ather eontrofled committee.
ELECT1Vf 6FFILES(3UGHTOR HfLU YEAR 6� ?ARTY
NAME OF CANDiBAFE/OFFiC'cHOLDERjSfA3E MEASi1RE PROPQN£NT (}NCLUDE DiST8kt7 NUMBER tF APPCtLABLE} ELfCT10N CF}ECK QNE
Nwxpartisan Partisan (list politicat party beiow}
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Nonpartisan Partisan (list po(iticat party betow)
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• • • Primarily�ormed to sv�part or oppose specific�and"sdates or me�su�es in a singie efectian. List beiow_
CANDtRATE(5)NAME 6R MEASllRE(Sj�ULtFfTLE(tNCLUBE BALLOT NO.OR CETtER} CANDiDATE{5}pFFlCE SQUGffT OR HELD OR MEASURE(S}1URISDtC'f10N
IE k RECALL,STATE"RECAtL IN FAQNT 1}F TtIE OFFILEHOLDER'S NAME jIf1LLUDE DiSTRICT N9.,CiTY OR COUN�1;AS AFPL#CABL£) CHECK ONE
5t3PPOR.T OPPOSE
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SUPPORT OPR�SE
E � 01._!
FPPC Form 410{August/2�35)
�PPC Aclvice:adudce@fppe.ca.gov j865/275-3772�
wutw fppc.ta.gov
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Si�eme�tt�f�rc�ar�@�atian t �- .
� �ec�pient Corx�mitt�e � . � i
� t1VSTRUCTlOfK ON REVERSE
Page 3
� t6MMlTfEE NAME I.D.N1IMBER
Guperfino Politicak Raforms PAC
4,Type of Committee: (co�fi���)
t�ot formed to su�port or appase speci�ic candiGa#es or tneas�res in a single electicsn. Check anly one box:
�cmr co��e ❑coc�n�rr c�,�,�►�� ❑srar€�r���t�
FRQVtDE BRIEF DFSCRIPTiON OF ACifV({3'
Prornote prfiiical re€arrrt artd ga�ernmee�t transpacency at C[apertino.
� • -• • List additianal sponsmrs on an attachment.
NAME OF SPONSOR INOUSfRY GROUP OR AFF[itAT10N OF SPONS4R
STREF{ABDRf55 iJO.ANDSTRfEF C(TY SfAl'E ZlPCD�E AREACOIIE/PtIQNE
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Date quati�ied
S.T�PI'1'11l18'U017 RE'QUIC6t17fl[1t5 Bysigning fhe verification,the treasurer,assistant treasurer and/or candidate,officehoider,ocproponent certify that ali of thefolfowing conditions tiave been,met:
� This committee has ceased to r2ceive contributions and make expen�lit�res; _ , _ _ _
• This commit#ee does not anfi�ipate receiving contrib�t�ons or makiflg expenditurss in ihe future;
• This committee has elimirrated or has r�a intention or abiiity#o discha�ge 21t debts,tcans received,and other obligations;
• This commit#ee has no surpius func{s;and
• This committee has filed alt carr�paig�t statemer.ts ret{u7re�E by the Potitical Reform A�t disclosing ali repoatable transactions.
— There are restsictions on#he disposition of surplus campaign funds held by electe�k Qfficers wha are leaving affice arrtl by defeated ca�didates. Refer to Gauernment
Code Section 89539.
— Leftover funds of battot measUre co:v�mi�iees may be usad#or political,legislative or go�ernmental{�urposes ur�der 6overnment Code Sections 89511-89518,and are
subject to Elections Code Section 18b80 and FPPC Regu[atian 1852�..5.
�PPC Form 41Q{A.ugustJ2028)
�PPC dldvice:advice@f�spc.ca.gov(8o6j275-3772)
www.#ppcca.gov