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410 Statement of Organization Recipient Committee – Initial Not Yet Qualified Amendment Stamped by SOS Statement of Organization Date Stamp Recipient Committee Statement Type ®Initial Amendment CEIVE€� AND FILE❑ Termination—See Pa For Official Use Only 0 Not yet qualified )n t e office of the Secretary of Sta or add P•3 of the State of California A U G 2�20 O Date qualification threshold met Date qualification threshold met Date of termination JUL L 2 4 2020 / / / / / / 4J �e Committee1. • I.D. Number / y� J x� Other Principal Officers NAME OF COMMITTEE NAME OF TREASURER Kitty Moore for Council 2020 Margaret S.Griffin STREET ADDRESS(NO P.O.BOX) 10727 Randy Lane STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE 867 Ferngrove Dr. Cupertino CA 95014 (408)314-0990 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY Cupertino CA 95014 (408)930-4459 Joan Chin FULL MAILING ADDRESS(IF DIFFERENT) STREET ADDRESS(NO P.O.BOX) P.O.Box 2109,Cupertino,CA 95015 10162 Bilich Place E-MAIL ADDRESS(REQUIRED)/PAX(OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE kitty4cupertino@gmail.com Cupertino CA 95014 (408)887-7435 COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S) Santa Clara County Cupertino STREET ADDRESS(NO P.O.BOX) Attach additional information on appropriately labeled continuation sheets. CITY STATE ZIP CODE AREA CODE/PHONE Verification3. 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 that h pre irrg is tru and correct. Executed on / v �G�i�d By ` DATE SI ATUR FTREASU RER OR ASSISTANT TREASURER Executed on 12-Z�) By DATE' SIGNATURE OF CONTROLLING OFFICEHOIeR,CANDIDATE,OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT FPPC Form 410(August/2018) FPPC Advice:advice@fppc.ca.¢ov(866/275-3772) r www.fppc.ca.¢ov Statement of Organization CALIFORNIA Recipient CommitteeFORM INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D.NUMBER Kitty Moore for Council 2020 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREACODE/PHONE BANK ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE 4. Type of Committee Com plete the applicable sections. • 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 Nonpartisan Partisan (list political party below) Catherine"Kitty"Moore Cupertino City Council 2020 Nonpartisan Partisan (list political party below) FormedPrimariiy 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) 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 SUPPORT OPPOSE FPPC Form 410(August/2018) FPPC Advice:advice@fopc.ca.gov(866/275-3772) r www.fpoc.ca.eov Statement of Organization CALIFORNIA ' Recipient Committee - INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D.NUMBER Kitty Moore for Council 2020 4.Type of Committee (Continued) General Purpose Committee 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 J STREET ADDRESS NO.AND STREET CITY STATE ZIP CODE AREA CODE/PHONE Small . • ❑ �� Date qualified S.Termination RequirementS signing the verification,the treasurer,assistant tri?asurer and/or candidate,officeholder;or ponent ceirtifV 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