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410 Statement of Organization Recipient Committee - Amendment (2) Statemen� of O�ganization Recipient Committee �' �-�' a "" ,� � . af � +� � �� � �J • ' • � 1 Statement Type �' �� � • ' lnitial � Amendment ❑ Termination—Se�Part 5 3 � � ���� For Official Use Only (� Not yet�qualified ��} �� ��� � ���� � , � � � � Date qualified as committee 10 ( ��zo�8 ______�-/ � � Date qualified as committee Date of termination ---✓ � ° ���_�'�:'tgP'' �+a-- ! R � �n�� :�r�Y ���= � �. 1. Committee Inf�rmation • ��D. Number (if applicab(e) 1412139 Z. Treasurer and Other Principal Officers NAMEOFCOMM7TTEE � � NAME OF TREASURER Cupertino Residents for Local Ethical Government Opposing Chao & Wi11ey ioY Gary E. Jones City Council 2018 STREETADDflESS(NO P.D.BOX) � - Nancy L Waxzen ScPtd Clara C011P_t NAMEOFPRINCIPALOFFICER(5} Y Cupertino Oscar Hur - � - � STREE7AODRESS(NO P.O.BOX) I have used al(reasonable diligence in preparing Executed on B DATE y . SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIOqTE,OA STATE MEASURE PROPONENT FPPC Form 410(February/2018j FPPC Advice:advice@fppc.ca.gov(866/Z75-3772) www.fppc,ca.gov ' Statement of Organization Recipient Committee . - . 1 INSTRUCTIONS ON REVERSE � ' COMMIlTEE NAME Page 2 oz 4 I.D.NUMBER Cupertino Residents for Local Ethical Government Opposing Chao & Willey £or City Council 2018 1�12139 Za. Additional Officers/Assistant Treasurers NAME NAME Michael Malik MAILING ADDRESS 4 MAILING ADDRESS � . NAME , NAME MAILING ADDRESS MAIUNG ADDRESS ��TM � STATE ZIP�CODE AREACODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE NAME NAME MAILING ADDRESS MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE CITY STATE ZIPCODE AREACODE/PHONE NAME NAME MAILING ADDRESS MAILWG ADDRESS C�N STATE ZIP CODE AREA CODE/PHONE C17Y STATE ZIPCODE AREACODE/PHONE www,ne�le.com FPPC form 410(February/2018) FPPC Advice:advice@fppc.ca.gov(866I275-3772) Www_fnnr.ca nnv Statement of Organization Reci�ient Committee • • - . � � INSTRUCTIONSONREVERSE � � COMMITTEENAME � . � Pagez Page 3 Of 4 Cupertino Residents �or Local Ethical Government Opposing Chao & Willey for City Council 2018 �•�•�'UMBER 1412139 • A11 committees must list the financiai institution where the campaign bank account is located. NAME OF FINANCIALINS7ITUTION � � � AREACODE/PHONE BANKACCOUNTNUMBER � Bank of San Francisco ( ADORESS Liif - � List the name of each controfling officeholder,candidate,or state measure proponent. If candid�te or ofFiceho�der controlled;also list the elective office sought or held,and district number,if any,and the year of the election. � �ist the political party with which each officeholder or candidate is affiliated or check"tlonpartisa�." Stating"No party preference"is acceptable. + If tI115 COITItYlitt2e 2Cts jointly with another contro(led committee,i�5t tne name and identification number of the other controlled committee. NAME OF CANDIDATE/OFFICEHOL�DER/STATE MEASURE PROPONENT EIECTIVE OFFICE SOUGHT OR HELD YEAR OF UNCLUDE DISTRICT NUMBER IFAPPUCABLE) ELECTION PARTY CHECKONE Nonpartisan Partisan (Iist politica�party below] Nonpartisan Partisan {list political party below) ' "' • ��- Primarify formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(5)NAME OR MEASURE(5)FULLTITLE{�NCLUDE BALLOT NO.OR LETTER) � � IF A RECALL,STATE"RECAIL'IN FRONT OF THE OFFICEHOLDER'S NAME. � � CANDIDATE(S)OPFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION (INCIUDE DISTRICT NO.,CI7Y OR COUNTY,AS APPLICABLEJ Liang-Fang Chao City'Couneil Member: Cupertino cHecKONe . ' � SUPPORT OPPOSE John Willey City Council Member: Cupertino X SUPPORT OPPOSE X FPPC Form 410(February/2018) FPPC Advice:advice@fppc.ca.gov{866/275-3772j www.fppc.ca.gov Statement of Organization Recipient Committee ` • " � ' � 1NSTRUCTIONS ON REVERSE � � COMMITTEENAME Page3 page 4 of a_ � � I.D.NUMBER Cupertino Residents for Local Ethical Government Opposing Ci1ao & Willey for City Council 2018 4.Type af Committee (Continued} 1�12139 ' " Not formed to support or oppose specific candidates or measures in a single election. CheCk only one box: ❑ CITY Committee ❑ COUNTY CommitEee❑ STATE Committee❑ Political Pa rty/Central CommitEee � PROVIDE BRIEF DESCRIPTION OP ACTIVITY ��• - List additional sponsors on an attaChment, NAMEOFSPONSOR � INDUSTRYGROUPORAFFIUATIONOFSPONSOR � � STREETADORESS NO.ANOSTREET � arr . STATE ZIP CODE� AREA CODE/PHONE I I ❑ � � Date qualified � S.Termination Requirements By signing the verification,the treasurer,assistant treasurer and/or candidate;officeholder,or proponent certify that all of the following conditions have been met: • This committee has ceased to receive contributions and make expenditures; • This COmmlttee 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 recei�red,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 futld5 held by e12Cted OfFICeI'S Who aPe leaving office and by defeated candidates. Refer to Government Code Section 89519. -- Leftover funds of balfot measure committees may be used for political, legislative or goverr�mental purposes under Government Code Sections 89511-89518,and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5. FPPC Form 410(February/2018) FPPC Advice:advice@fppcca.gov(866/275-3772} www.fppcca_gov