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410 Statement of Organization Recipient Committee – Amendment Stamped by SOSExecuted on By DATE SIGNATII RE OF CONTROLLING OFFICEHOL[)ER, CANDIDATE, OR STATE MEAFu RE PRCIPONENT Executed on By DATE SlGNATll RE OF CONTROulNG CIFFICEHOIJ)ER, CANDI I)ATE, OR ST ATE MEASIIRE PROPONENT FPPC Form 410 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME Kitty Moore far Council 2020 0 All committees must list the financial institution where the campaign bank account is located. 1.0. NIIMBER 1428355 NAME C)F FINANCIAL INSTITkJTION Wells Fargo Bank AREA COII)E/PHONE ( CITY Cupertino BANK ACCOLINT NLINIBER STATE CA ZIP CODE 95014 I 11111sags 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 PART/ NAME OF cANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELE(T10N CHEI ONE Catherine "Kitty" Moore City Council Member City City of Cupertino 2020 Nonpartisan [;] Partlsan € ilist politlcal party beliiwl Nonpartisan € Partlsan D (list piilitical party below) ffllrgg4ffTiH Primarilyformedtosupportoropposespecificcandidatesormeasuresinasingleelection.Listbelow: CANDIDATE(S) NAME OR MEASURE(S) FULLnTLE IINCLUDE BALLOT NO. OR LETTER) IF A RECALL, STATE "RECALU' IN FRONT OF THE OFFICEHOLDER'S NAME. CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CIT/ OR COUNTY, AS APPLICABLE)CHECK UNE SuPPC)RT € OPPOSE € SIIPPORT € OPPOSE € FPPC Form 410 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 3 COMMITTEE N AME l.[). NO MBER Kitty ttocre for Coa.'n:i' 2020 1428355 i; 4i&(ilftiiL - OrT'mgWWTl4T7T71l'i hirit 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 ACTIVITY ia i - n a " List additional sponsors on an attachment. STREETADDRESS NO. ANDSTREET CITY STATE ZIP CODE AREA CODE/PHONE §l'T'fT7r/' I, J Date qualified I @ * 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 ii 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 funds held by elected officers who are leaving office and by defeated candidates. Referto Government Code Section 89519. - Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511- 89518, and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5. FPPC Form 410 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov :orm;AID Additional Notes NOTES Page 4 of 4