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410 Statement of Organization Recipient Committee – AmendmentStatement of Organization Date Stamp ,"F0,0MI'dal Recipient Committee ECERVEStatement Type ❑ Initial ® Amendment ❑ Termination — See Part 5 U se Only Q Not yet qualified JUL 25, 2022 or Q Date qualification threshold met Date qualification threshold met Date of termination --/� _12L_/ 22/ 2QR2 -/-/ CUPERTINO CITY CLERK 1. Committee InformationI.D. Number 1450210 2. Treasurer and Other (i ovclicable NAME OF COMMITTEE NAME OF TREASURER Nicole Woon (; qn q � �0 r QL&H-i no C1 Q) M C- ( 2a 2 2 STREET ADDRESS (NO P.O. BOX) .1 f STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Cupertino CA 95014 CITY STATE ZIPCODE AREACODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Cupertino CA 95015 FULL MAILING ADDRESS (If DIFFERENT] STREET ADDRESS (NO P.O. BOX) E-MAILADDRESS RE UIR F X CITY STATE ZIP CODE AREA CODE/PHONE COUNTY OF DOMICILE RISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S) Santa Clara 7Cupertino Chao, Liangfang STREET ADDRESS (NO P.O. BOX) Attach additional information on appropriately labeled continuation sheets. CITY STATE ZIP CODE AREA CODE/PHONE 3. Verification Cupertino CA 95014 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 Executed on 1 (1 S /� B DaTE Executed on _Zj�jZZ g DATE 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.goy (866/275-3772) www.fypr-.Ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME Liang Chao for Cupertino City Council 2022 • All committees must list the financial institution where the campaign bank account Is located. NAME OF FINANCIAL INSTITUTION AREACODE/PHONE BANKACCOU NTNUMBER Wells Fargo Bank - ADDRESS CITY STATE ZIP CODE Cupertino CA 95014 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 . NUMBER 1450210 • 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 Chao, Liangfang Cupertino City Council 2022 Nonpartisan Partisan (list political party Nonpartisan Partisan (list political party CommitteePrimarily Formed 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 APPI IrARI Fl FPPC Form 410 (August/2018) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fooc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME LD. NUMBER Liang Chao for Cupertino City Council 2022 1450210 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 an an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRE55 NO, AND STREET CITY STATE ZIP CODE AREA CODE/PHONE Small Contributor Committee Date qualified Termination5. e • 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 (8661275-3772) www.fppc.ca.gov