410 Statement of Organization Recipient Committee – Amendment �
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Statement of Qrganization ����� ae amP `- � � . �
Recipient Committee � � � j !
Statement T e ��� � � • �
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0 Amendment ❑ Terminafion—SeePart � � ���� � � ���� � ��� ForOfficialUse�nty
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�Date qualified as committes �$ � 06 j 2018 —�
� 06 t 20�$ Qate qualified as committee Date of termination � � ��� ����� �� �� ��� �
1. Commrt�ee Informafion `� I.D. Number � � �� �� � �� �
� �� �' �� �� (�f�PPlrcabte) 1408452 � 2 Treasu�er and�?f6�r�l�rit�ctpal;,L2fficers
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NAME�PCOMMITTEE V � �� NAAqE OF TREASUBER
Jon Willey for Cupe►tino Council 2018
Joan Lawler Chin
Eric Shaefer
COVNTY OF OOMICIIE 1URISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINGPA!OFPICER{5)
Santa Gara ity of Cupertino
STREET ADDRESS(NO P.O.BO%)
Attach additionalin ormotion on a ��TM STATE ZIPCO�E qREACODE/PHONE
f ppropriately labe%d continuation sheets.
3,_Veri� eatio�
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I have used all reasQnable diligence�in preparing�this statement�and to the best of my knowledge the information contained iterein is true and complete. !certify undeC ��
penalty of perjury under the laws of the State
MEASURE PROPONENT
Executed on BY
�A7E SIGNATURE OF CONTROLLING OFFiCEHOLDER,CANOIDATE,OR SiATE MEASURE PROPONEN7
Executed on gv
DA7E
SIGNATURE OF CONTROLLING OFFICEHOIDER,CANDIDATE,OR STATE MEASURE PROP�NENT
FPPC Form 410(February/2018)
FPPC Advice:advite@fppc.ca.gov(8fi6j275-3772)
www.fppc.q.gov
Statement of Organization � � . ,
Recipient Committee � . � �
INSTRUGTIOR7S ON REVERSE
Page 2
COMMI7TEE NAME
I.D.NUMBER
Jon Willey for Cupertino Council 2Q18 1408452
• AII tommittees must Iist the financial institution where the campaign bank account is located.
NwrtqE OF FINANCIAltNSTRUTION
7620918875
t#�.T}tpe t3 Go[nrn��Eee CampleCe th�applieabte seetEQns.� � � � � �, .
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• List tfie 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:' Stating"No party preference"is acceptable.
• If this committee ads jointly with another controlled committee,list the name and identification number of the other contralled committee.
ELEQIVE OPFICE SOUGHTOR HEID YEAR OF PARTY
NAMEOf CANDIDATEJOFFICEHOLDER/57ATE MEASURE PROPONENT pNCLUQE DISTRICTNUMBER IFaPPlICRB�Ej ELECTION [HECKONE
Nonpartisan Partisan {list political party belowj
Jon Willey Cupertino City Council 2018 � �
Nonpartisan Partisan (list political party 6etow)
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�� - � Primarily formed to support or oppose specific candidates or measures in a single election. List below:
GANDIDATE(S)NAME OR MEASURE{5)PULLTITLE(MC�UDE BALLOT NO.OR LETTER) CANDIDATE{S)OPFICE SOUGHT OR HEID OR MEASURE�S}1URISDItTIQN
IF A RECAlL,STATE"RECALL'IPf PRONT OF THE OPFlCEHOLDER'S NAME. {�NCW DE DISTRICT NO_,CITY OR COUNT;AS APPLICAB�E} CHECK ONE
SUPPORT QPPOSE
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SUPPORT OPPOSE
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FPPC Form 410(Februaryf 2018)
FPPC Advice:advice@fppc.ca.gov{866/275-3772}
www.fppc.ca.gov