410 Statement of Organization Recipient Committee - Amendment Reassign for 2020 Stamped by SOSStatekioent of Organization
Recipient Committee
Statement Type ❑ Initial 0 Amendment
0 Not yet qualified
or
0 Date qualification threshold met Date qualification threshold met
07 / 30 / 2014
1. Committee Information I.D. Number
(if applicable) 1369332
NAME OF COMMITTEE
ROBERT MCCOY FOR COUNCIL 2020
❑ Termination — See
STRFETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
FULL MAILING ADDRESS IIF DIFFERENT)
E-MAILADDRESS (REQUIRED) / FAX (OPTIONAL)
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
Attach additional information on appropriately labeled continuation sheets.
Date of termination
Date Stamp
;E1VED AND, F11
office of the Secretary of
of the State of California
FEB 2 5 2019
For Official Use Only
LIAR 2 5 2019
-/-/- UPERTINO CITY CLERK
2. Treasurer and Other Principal Officers
NAME OF TREASURER
BLOSSOM MCCOY
STREET ADDRESS (NO P.O. BOX)
CITY
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
CITY
STATE
ZIP CODE
AREA CODE/PHONE
NAME OF PRINCIPAL OFFICER(S)
STREET ADDRESS (NO P.O. BOX)
CITY
STATE
ZIP CODE
AREA CODE/PHONE
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 forengoini is true and correct.
Executed on 02/22/2019 By
OR ASSISTANT TREASURER
Executed on 02/22/2019 By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
DAIE
Executed on
DATE
By
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Staitemant of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
ROBERT MCCOY FOR COUNCIL 2020
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
BANK OF AMERICA 1( 1325092739200
ADDRESS
CITY
STATE ZIP CODE
4. Type of Committee Complete the applicable sections.
Page 2
I.D. NUMBER
1369332
• 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 party with which each officeholder or candidate is affiliated or check "nonpartisan." Stating "No party preference" is acceptable.
• 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 YEAR OF PARTY
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
PrimarflY 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)
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
SUPPORT
0
Nonpartisan
Partisan
(list political party below)
ROBERT MCCOY
CITY COUNCIL
2020
❑✓
0
Nonpartisan
Partisan
(list political party below)
0
❑
PrimarflY 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)
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
SUPPORT
0
OPPOSE
0
SUPPORT
0
OPPOSE
0
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov