410 Statement of Organization Recipient CommitteeStatement of Organization Recipient Committee ,---------------r-------------r-------------H-t:.: <, Statement Type D Initial 00 Amendment D Termination -See Part Ii CAUFORNIA 41 Q FORM For Official Use Only Q Not yet qualified AUG 2 ~ 2023 or Q Date qualification threshold met Date qualification threshold met Date of termination CUPERTINO CITY C ERK 1. Committee Information NAME OF COMMITTEE 1.0. Number (if applicable} Gilbert Wong for Cupertino City Council 2024 STREET ADDRESS (NO P.O. BOX) 10785 Peninsular Ave CITY STATE ZIP CODE Cupertino CA 95014 FULL MAILING ADDRESS (IF DIFFERENT) 10785 Peninsular Ave Cupertino, CA. 95014 E-MAIL ADDRESS (REQUIRED)/ FAX (OPTIONAL) g ilbertswong@gmail.com COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE Santa Clara County City of Cupertino 1382149 AREA CODE/PHONE 4083168038 Attach additional information on appropriately labeled continuation sheets. 3. Verification 2. Treasurer and Other Principal Officers NAME OF TREASURER Helen Kwan STREET ADDRESS (NO P.O. BOX) 22103 Hibiscus Court CITY STATE ZIP CODE Cupertino CA 95014 NAME OF ASSISTANT TREASURER, IF ANY Gilbert Wong STREET ADDRESS (NO P.O. BOX) 10785 Peninsular Ave CITY STATE ZIP CODE Cupertino CA 95014 NAME OF PRINCIPAL OFFJCER(S) STREET ADDRESS INO P.O. BOX) CITY STATE ZIP CODE CA 95014 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. penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executedon 2024-08-29 By ~ ~~ DATE Executed on 2024-08-29 By SIGNATUR~RER t::;.~URER DATE Executed on 2024-08-29 By DATE E MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT AREA CODE/PHONE 4083168038 AREA CODE/PHONE 4083168038 AREA CODE/PHONE 4083168038 I certify under FPPC Form 410 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov
Statement of Organization Recipient Committee CALIFORNIA 41 Q FORM INSTRUCTIONS ON REVERSE COMMITTEE NAME Gilbert Wong for Cupertino City Council 2024 1.D. NUMBER 1382149 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER Wells Fargo Bank 4088636100 3094144528 ADDRESS CITY STATE ZIP CODE 10260 De Anza Blvd. Cupertino CA 95014 4. Type of Committee Complete the applicable sections. Controlled Committee • 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. NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY CHECK ONE Nonpartisan Gilbert Wong Cupertino City Councilmember 0 Nonpartisan □ Primarily 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) Partisan □ Partisan □ (list political party below) (list political party below) 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 COMMITTEE NAME Gilbert Wong for Cupertino City Council 2024 4. Type of Committee (Continued} CALIFORNIA 41 Q FORM 1382149 General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box: l:if) CITY Committee O COUNTY Committee O STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY Sponsored Committee List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE Small Contributor Committee □-1--1 Date qualified S. Termination Requirements By signing the verification, the treasurer, asslstant 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. 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. 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