410 Statement of Organization Recipient Committee - AmendmentStatement of Organization Date Stamp Recipient Committee Statement Type .... lll]-ln-it-ia_l _______ ..,.l _________ I ________ ___JI D Amendment D Termination -See Part 5 0 Not yet qualified or 0 Date qualification threshold met I Date qualification threshold met Date of termination 08 1 08 I 202:i I --./ _ _,__ l __ / __ / __ I.D. Number (if applicable) NAME OF COMMITTEE NAME OF TREASURER Moon Kyu Choe for Cupertino City Council 2022 Jon Michael Vitalich STREET ADDRESS (ND P.O. BOX) 19503 Stevens Creek Blvd, STE 312 STREET ADDRESS (NO P.O. BOX) CITY 19503 Stevens Creek Blvd, STE 312 Cupertino CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Cupertino CA 95014 408 359 7070 FULL MAILING ADDRESS (IF DIFFERENT) STREET ADDRESS (NO P.O. BOX) E·MAIL ADDRESS (REQUIRED)/ FAX (OPTIONAL) CITY moonkyuchoe@gmail.com COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S) Santa Clara Cupertino Moon Kyu Choe STREET ADDRESS (NO P.O. BOX) 19503 Stevens Creek Blvd, STE 312 CITY Attach additional information on appropriately labeled continuation sheets. Cupertino STATE CA STATE STATE CA CALIFORNIA 410 FORM For Official Use Only ZIP CODE AREA CODE/PHONE 95014 831 277 0510 ZIP CODE AREA CODE/PHONE ZIP CODE AREA CODE/PHONE 95014 408 359 7070 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. penalty of perjury under the laws of the State of California that the foregoing is true and correct. I certify under E t d 08/26/2022 xecu e on DATE Executed on 08/26/2022 DATE Executed on DATE Executed on DATE By By By By --+---= .. --=== .. -... ·-----==··"··---·-=---· .. ------~-SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (August/2018) FPPC Advice: <!dvice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov
Statement of Organization Recipient Committee CALIFORNIA 410 FORM INSTRUCTIONS ON REVERSE Page2 COMMITTEE NAME 1.D. NUMBER Moon Kyu Choe for Cupertino City Council 2022 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER Wells Fargo Bank 408 863 6100 8623265298 ADDRESS CITV STATE ZIP CODE 10260 S De Anza Blvd Cupertino CA 95014 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. NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY CHECK ONE Moon Kyu Choe Cupertino City Council 2022 Nonpartisan ./ Nonpartisan Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) NAME OR MEASURE($) 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) Partisan Partisan (list political party below) (list political party below) CHECK ONE SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 410 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.f~ov
Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME CALIFORNIA 410 FORM General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box: 0 CITY Committee O COUNTY Committee O STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY Sponsored Committee List additional sponsors on an attachment. NAME Of SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE Small Contributor Committee □--1--1--Date qualified .::'-s: Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or ponent certify 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