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410 Statement of Organization Recipient Committee - Amendment 8-6-24 Stamped by SOS and ROVStatement of Organization Recipient Committee Statement Type ❑ Initial Amendment ❑ Not yet qualified or m Date qualification threshold met Date qualification t 7 / 11 / 202A 7 / 11 / 2011 1. 1A n i _ _ftfornmNoT LD. Number 1471161 NAME OF COMMITTEE R "Ray" Wang For Cupertino City Council 2024 pF-CF-odF- n1 Ifir "7- , , I] CUE Termination - fee P INO TY tp ERK natic STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Cupertino9 CA 95015 FULL MAILING ADDRESS (IF DIFFERENT) E-MAIL ADDRESS OF COMMITTEE (REQUIRED)/ FAX (OPTIONAL) COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE Santa Clara I City of Cupertino Attach additional information on appropriately labeled continuation sheets. NAME OF TREASURER Jon Willey Date Stamp DIGITALLY rt 5 RECEIVED AND FILED in the office of the California Secretary of State JULY 18 2024 STREET ADDRESS (NO P.O. BOX) CITY Cupertino EMAIL ADDRESS OF TREASURER (REQUIRED) NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS (NO P.O. BOX) CITY EMAIL ADDRESS OF ASSISTANT TREASURER (REQUIRED) NAME OF PRINCIPAL OFFICER(S) R Wang STREET ADDRESS (NO P.O. BOX) CITY Cupertino EMAIL ADDRESS OF PRINCIPAL OFFICER(S) (REQUIRED) For Official Use Only JUL 2 9 2024 REGISTRAR OFVO COU PITY OF SANTA. i STATE ZIP CODE CA 95014 AREA CODE/PHONE STATE ZIP CODE AREA CODE/PHONE STATE ZIP CODE CA 95015 AREA CODE/PHONE, 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 foregoing is true and correct. _ DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT 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 FPPC Form 410 (October/2023) FPPC Advice: advicePfppc.ca.gov (866/275-3772) www.fppc.ca.eov �$Eatement'of'Organization CALIFORNIA , Recipient CommitteeFORM INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER R "Ray" Wang For Cupertino City Council 2024 1471161 All committees must list the financial institution where the campaign bank account is located and the person(s) authorized to obtain bank records. NAME OF FINANCIAL INSTITUTION AND PERSON(S) AUTHORIZED TO OBTAIN BANK RECORDS AREA CODE/PHONE BANK ACCOUNT NUMBER US Bank Henry Ghazanchian ( ;ADDRESS OF FINANCIAL INSTITUTION CITY STATE ZIP CODE Saratoga CA 95070 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. ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE R "Ray" Wang City of Cupertino - City Council 2024 Nonpartisan ✓ Partisan (list political party below) Nonpartisan Partisan (list political partybelow) FormedPrimarily 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) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE SUPPORT OPPOSE . SUPP.Ok`r, OPPOSE FPPC Form 410 (October/2023) FPPC Advice: advice@fPPc.ca.eov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME R "Ray" Wang For Cupertino City Council 2024 Not 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 List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR Page 3 I.D. NUMBER 1471161 STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE Date qualified • 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 (October/2023) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov