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410 Statement of Organization Recipient Committee - Initial 1-9-19 T ENT OF ORGANIZATION Staternent of Organization Type or print in ink. �j �C .- ' Recipient Committee �_ , Statement Type � Initial ❑Amendment ❑ Termination-See Part 5 Not yet qualified ❑ or List I.D.number. List I.D.number: ���,! ✓ ��'�� 1 af 3 # # s/li/2oi2 Date qualified as committee Date qualified as committee Date ofTermination l���F'i t t�t3 Vt i I V�� � 1. Committee Information 2. Treasurer and Oth�r Principal Officers NAME OF COMMITTEE NAME OF TREASURER SILICON VALLEY TAXPAYERS ASSOCIATION PAC Steven Haug STREET ADDRESS NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S),IF APPLICABLE COUNIY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE Mark Hinkle - President 3. Verification I 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 under the laws of the State of California that the foregoing is true and correct. Executed on 1/�/zol9 gy ��� Executed on gy DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on gy DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on gy DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT FPPC Form 410(Dec/2012) FPPC Toll-Free Helpline: 866/ASK-FPPC(866/275-3772) 2332618-0 STATEMENT OF ORGANIZATION Statement of Organization � .� � a 1 Recipient Committee INSTRUCTIONS ON REVERSE Page 2 of 3 COMMITTEE NAME I.D.NUMBER SILICON VALLEY TAXPAYERS ASSOCIATION PAC 1347578 •All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER ADDRESS CIN STATE ZIP CODE 4. Type of Comm ittee 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 pofitical party with which each officeholder or candidate is affiliated or check"non-partisan�. • If this committee acts jointly with another controlled committee, list the name and identification numher of the other controlled comrnittee. EFFECTNE OFFICE SOUGHT OR F-!ELD NAME OF CANDIDATE/OFFICE HOLDER/STATE MEASURE PROPONENT INCLUDE DISTRICT NUMBER IF APPLICABLE YEAR OF ELECTION PARTY ❑ Non-Partisan ❑ Non-Partisan • -� � Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION CANDIDATE S NAME OR MEASURE S FULL TITLE INCLUDE BALLOT NO.OR LETTER (WCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABL� CHECK ONE SUPPORT OPPOSE ..._...,_..�..._,._.-..._<_.....�.�._.,��..,......�...,... ❑ ❑ - ..� - . . .. . 4 .. , .S ,.. .2: f ,, . �. � ....... _.., ._ .._..:..... ..........:,_,-...�.; .,q �.. . . � ....., � � � � .. 4�� � . .. � _ ' � EPRC Form 410(DeG2012) 'FPP��o�ti F�ee Tiefp"[ine 866lASK=FPPC(866/275-3772) �t �332618=� . ��...._�r..m.,...�.. ...�,.,�,.....�,._,�». STATEMENT OF ORGANIZATION Statement of Organization �_ . Recipient Committee �- ' ' INSTRUCTIONS ON REVERSE Page 3 of 3 COMMITTEE NAME I.D.NUMBER SILICON VALLEY TAXPAYERS ASSOCIATION PAC 1347578 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 ❑ COUNTY Committee � STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTMTY Support and oppose state and local ballot measures and candidates " ' �' ' List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS GITY STATE ZIP CODE ' • • • � Check box and provide the date this committee qualified as a small contributor committee. If the committee qualified as a Date qualified small contributor committee on January 1,2001,enter 1/1l01. rJ. 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 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. o• 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. FPPC Form 410(Dec/2012) FPPC Toll-Free Helpline: 8661ASK-FPPC(866/275-3772) 2332618-0