410 Statement of Organization Recipient Committee – Amendment (2) 09-15-23Statement of Organization Recipient Committee Statement Type 1.-□-l-ni-tia-1--------,1.-----------r-l --------++Hit\ I Ill Amendment D Termination -See Part 0 Not yet qualified or 0 Date qualification threshold met I Date qualification threshold met 07 ./ 22 / 2022 1450210 NAME OF COMMITTEE LIANG CHAO FOR CUPERTINO CITY COUNCIL 2022 STREET ADDRESS (NO P.O. BOX) 12248 Goleta Ave CITY STATE ZIP CODE AREA CODE/PHONE Saratoga CA 95070 408-218-7125 FULL MAILING ADDRESS (IF DIFFERENT) E-MAIL ADDRESS (REQUIRED)/ FAX (OPTIONAL) COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE SANTA CLARA CUPERTINO Attach additional information on appropriately labeled continuation sheets. Date of termination NAME OF TREASURER BRUCE LEONG STREET ADDRESS (NO P.O. BOX) 12248 GOLETA AVE CITY ·sARATOGA NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO P.O. BOX) CITY NAME OF PRINCIPAL OFFICER(S) Chao, Liangfang STREET ADDRESS (NO P.O. BOX) 10175 McLaren Pl CITY Cupertino SEP 5 2023 STATE ZIP CODE AREA CODE/PHONE CA 95070 408 806-8762 STATE ZIP CODE AREA CODE/PHONE STATE ZIP CODE AREA CODE/PHONE CA 95014 408 218-7125 I have usedaTlreasonafiTe-dlligence in preparing this statement and to the best of my knowledget:heinformation contained herein is true and corriplet:e. I certify under penalty of perjury under the laws of the State of California that the fore~g~g true and correct. Executed on 09/15/23 DATE By ~ ,.. r,~;;.;;f;.r-==-=-•rr,r~ .. ,~~"w""r" Executed on 09/15/23 DATE Executed on DATE Executed on DATE By ~ SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT By------SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT By--------------------------------------------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
Statement of Organization Recipient Committee CALIFORNIA 41 0 FORM INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER LIANG CHAO FOR CUPERTINO CITY COUNCIL 2022 1450210 • 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 408 863-6100 6220479551 ADDRESS CITY STATE ZIP CODE 10260 S DE ANZA BLVD CUPERTINO CA 95014 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 Chao, Liangfang Cupertino City Council 2022 Nonpartisan ./ 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) CHECK ONE SUPPORT OPPOSE SUPPORT SUPPORT 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 COMMITTEE NAME CALIFORNIA 41 0 FORM General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box: 0 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 5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or ponent 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: advi~e@fppc.ca.gov {866/275-3772) www.fppc.ca.gov