410 Statement of Organization Recipient Committee – Initial Not Yet Qualified Stamped by SOSStatement of Organization
Recipient Committee
Statement Type ® initial ❑ Amendment
Qj Not yet qualified
or
O Date qualification threshold met Dale qualification threshold met
• I.D. Number
ifa lfcoble)
NAME OF COMMITTEE
CIiARLENE LEE FOR CUPERTINO CITY COUNCIL 2020
Termination — See Pa
Date of termination
Date Stamp
e office of the Secretery of
of the State of California
OCT 14 2020
NAME OF TREASURER
CHARLENE SI-IULIEN LEE
For Official Use On(
020
STREET ADDRESS (NO P.O. BOX) CITY - - - STATE ZIP CODE AREA CODE/PHONE
CUPERTINO CA 95014
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY
CUPERTINO CA 95014 —
FULL MAILING ADDRESS (1F DIFFERENT) STREETAODRESS (NO P.O. BOX)
E-MAIL ADDRESS (REQUIRED)/FAX (OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S)
SANTA CLARA CITY OF CUPERTINO
STREET ADDRESS (NO P.O. BOX)
CITY Attach additional information on appropriately labeled continuation sheets. STATE ZIP CODE 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.
Executed on By
DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER
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
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STALE MEASURE PROPONENT
FPPC Form 410(August/2018)
FPPC Advice: adviceCaDfppc.ca.goy (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Page 3
COMMITTEE NAME I 1.0. NUMBER
CHARLENE LEE FOR CUPERTINO CITY COUNCIL 2020
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
RUN FOR CUPERTINO CITY COUNCIL
List additional sponsors on an attachment.
NAME OF SPONSOR
STREETADDRESS NO, AND STREET
CITY
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STATE ZIP CODE AREA CODE/PHONE
Small Contributor Committee ❑ % 1
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 (August/2018)
FPPC Advice: advice(@fpoc.ca.eov (866/275-3772)
www.fpac.ca.Kov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
CHARLENE LEE FOR CUPERTINO CITY COUNCIL
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION
ADDRESS
AREA CODE/PHONE
CITY
BANK ACCOUNT NUMBER
STATE VII CODE
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.
Page 2
I.D. NUMBER
• 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 rurrr nn�c
CHARLENE LEE
2020
Nonpartisan
Partisan
(list political party below)
CUPERTINO CITY COUNCIL
Nonpartisan
Partisan
(list political party below)
FormedPrimarily Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURES) 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: advicePfooc.ca.gov (866/275-3772)
www.fopc. ca. F,ov