410 Statement of Organization Recipient Committee - Initial Not Yet QualifiedDR
AFT
Statement of Organization
Recipient Committee
CALIFORNIA
FORM 410
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASUREPROPONENTDATE
For Official Use Only
1. Committee Information I.D. Number
if applicable)
3. Verification
DATE
DATE
DATE
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.
Executed on
Executed on
Executed on
Executed on
Date Stamp
By
By
By
By
Statement Type Initial
Not yet qualified
or
Date qualification threshold met
Termination – See Part 5
Date of termination
Amendment
Date qualification threshold met
2. Treasurer and Other Principal Officers
NAME OF COMMITTEE
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
FULL MAILING ADDRESS (IF DIFFERENT)
NAME OF TREASURER
NAME OF ASSISTANT TREASURER, IF ANY
Attach additional information on appropriately labeled continuation sheets.
E-MAIL ADDRESS OF COMMITTEE (REQUIRED) / FAX (OPTIONAL)
CITY STATE ZIP CODE
NAME OF PRINCIPAL OFFICER(S)
STREET ADDRESS (NO P.O. BOX)
FPPC Form 410 (October/2023)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
AREA CODE/PHONEEMAILADDRESSOFTREASURER (REQUIRED)
CITY STATE ZIPCODESTREETADDRESS (NO P.O. BOX)
AREA CODE/PHONEEMAILADDRESSOFASSISTANTTREASURER (REQUIRED)
CITY STATE ZIPCODESTREETADDRESS (NO P.O. BOX)
AREA CODE/PHONEEMAILADDRESSOFPRINCIPALOFFICER(S) (REQUIRED)
DR
AFT
Statement of Organization
Recipient Committee
CALIFORNIA
FORM 410
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT
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.
4. Type of Committee Complete the applicable sections.
COMMITTEE NAME I.D. NUMBER
Page2INSTRUCTIONSONREVERSE
Controlled Committee
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)
Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below:
ELECTIVE OFFICE SOUGHT OR HELD
INCLUDE DISTRICT NUMBER IF APPLICABLE)
SUPPORT
PARTY
SUPPORT
OPPOSE
OPPOSE
CHECK ONE
CHECK ONE
YEAR OF
ELECTION
NAME OF FINANCIAL INSTITUTION AND PERSON(S) AUTHORIZED TO OBTAIN BANK RECORDS
ADDRESS OF FINANCIAL INSTITUTION STATE ZIPCODECITY
All committees must list the financial institution where the campaign bank account is located and the person(s) authorized to obtain bank records.
AREA CODE/PHONE BANK ACCOUNT NUMBER
Nonpartisan Partisan (list political party below)
list political party below) Nonpartisan Partisan
FPPC Form 410 (October/2023)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
DR
AFT
Statement of Organization
Recipient Committee
CALIFORNIA
FORM 410
COMMITTEE NAME I.D. NUMBER
Page3INSTRUCTIONSONREVERSE
5. Termination Requirements
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. 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.
General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
List additional sponsors on an attachment.
NAME OF SPONSOR
Sponsored Committee
STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
4. Type of Committee (Continued)
By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or ponent certify that all of the following conditions have beenmet:
CITY Committee COUNTY Committee STATE Committee
Date qualified
Small Contributor Committee
FPPC Form 410 (October/2023)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
October 09, 2024
MIKE MALIK
WANG AND MOORE FOR COUNCIL 2024; COMMITTEE TO OPPOSE, ID# 1476195
CUPERTINO CA 95014
Emailed to:
The above committee’s Recipient Committee Statement of Organization (Form 410) has been successfully processed.
The assigned ID number is 1476195. Questions regarding the processing of this filing may be sent to
form410@sos.ca.gov.
The ID number should be provided on all statements and reports filed by the committee and provided to any person or
committee to whom a contribution is made.
Amendments
When information contained in the committee’s Statement of Organization changes, file an amendment within 10 days
of the change with the Secretary of State. Under certain conditions the committee may be required to file an
amendment within 24 hours as described in the form’s instructions. For more information regarding this requirement
and other obligations, refer to the Campaign Rules found at https://www.fppc.ca.gov/learn/campaign-rules.html.
Annual Committee Fees
Committees must pay an annual $50 fee to the Secretary of State no later than 15 days after filing the Form 410
disclosing the committee qualification date. The reoccurring fee is then due no later than January 15th of each year,
until the committee is terminated. Failure to pay the fee results in a $150 penalty, for a total assessment of $200.
The fee can be paid online at
https://www.sos.ca.gov/campaign-lobbying/campaign-filing/committee-annual-fee-pay-online or by check mailed to:
Political Reform Division, Secretary of State, 1500 11th Street, Room 495, Sacramento, CA 95814.
Filing Disclosure Requirements and Obligations
Filing schedules for specific election dates, and the most recent versions of all forms and requirements are posted on
the FPPC’s website at:
https://www.fppc.ca.gov/learn/campaign-rules/where-and-when-to-file-campaign-statements/when-to-file-campaign-sta
tements-state-local-filing-schedules.html.
Local committees should check with the local jurisdiction to determine filing obligations and whether electronic filing is
required.Local jurisdictions may also post filing schedules that include additional local reporting requirements.
How to Terminate
Recipient committees may only terminate when they have met all the termination requirements in the form
instructions. After the termination requirements are met, complete page one of the Form 410 and mark the termination
box and provide a valid date of termination. Send the completed Form 410 to the Secretary of State. Send the Form
450 or 460 Termination to the local jurisdiction.