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410 Statement of Organization Recipient Committee – Initial Not Yet Qualified Stamped by SOSExecuted on DATE DATE 87 SIGN ATU RE OF CONTROLLING 01-FICE 110LDER, CANDIDATE, OR STATE MEASu RE PROPONENT I SIG NATllRE OF CONTROLLING OFFICEHOLDER, CANOID ATE, OR STATE MEASURE PROPON ENT I FPPC Form llD (August/2018 FPPC Advice: mvi<e(!t)fppc.ca.@'ov (866/275-377;!1 www.fppc.ca.gay Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME Yuko for Cupeitino City Coui"icil All committees must list the financial institution where the campaign bank account is located, Page 2 my List the name of each controlling officeholder, carididate, 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 elect'on. List the political party with which each officeholder or candidate is affiliated or check "nonpartisan." Stating "No party preference" is acceptable If this commitfee acts jointly with another controlled committee, list the name and identification number of the other controlled committee. NAME OF CANDIDATE/OFFICEHOL[)ER/STATE MEASIIRE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NLIMBER IF APPLICABLE) YEAR OF EtECTION PARTY C)IECK ONE Yuko Shima Cupertino City Council Member 2022 Nonpartisan { Pa Ps;i n [list piilihcal party below) I NonparHsan Paitisan lstx:hcapaqbeow) I I a H I * H( - * - H H I - F:rimarily formed to support or oppose specific candidates or measures in a single electiqn'.' List below: CANDIDATE[S) N AM E OR MEASIIRE(S) FULL TITLE (INCLUDE BAILOT NO. OR LETTER) F A RECALL, STATE "REC Au" IN FRO NT OF TH E O FFI CEHO LD ER'S N AM E. CANDIDATE(S) OFFICE SOUGHT OR HELD OR IXEASIJRE(S)JURISDICTION (ixccuoe DISTRICT NO., CITY OR COLINTY, AS APPLICABLE)CHECK ')N[ SUPPORT OPPOS[ Sll"PORT CIPPOSE FPPC Form 410 (August/2018) FPPC AdViCe: advice@fppc.caat'ov r866/275-377:!) ww.fppc.ca.gcv