410
Statem~nt of 4rganization ~ TEMENT OF ORGAPiiZATiON
Type or print in i~k
RecipiQnt Cammittee - ~ mp
~
~ ~
S4atement Type ~Initial Amendment 0 Tertninateon-See F~art ,_!r=~' : . F~.ptfic~aitlseUniy
Not yet quali~!ed or Lis~ i.D. numl~r. List I.O. rsumr,er: + i{
L R
. i~ # ? 237120 ~ n ( :
C~ ~pF~? , It~ _ YTY Ct_E K
~a 1 c~ , oa ~
Qate quaiif~d as comenittee Dat~ quaiifie~ as ax*tmi~tte~e i~ate oi i
e~ninat+~~
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1. Comr~nitte~: ~nfarmat~on 1'rea$urer and Qther Principal Officers
NAME 6F CC~MMSTTEE NAME OF TREASl1RER
Re-elect Mayor Patrick Kwok Ciae~iia Ch~ng ~
STREET AQDRESS~
'0222 Carrr?en R~
STREET ADDRESB ~NQ ~O FsJX) ~ ' STarr Z?? C~)UF AREA G6r,~,~p~(~E
1f3222 Ca~~n Rd Gupertir~~ CA 95014 408.257.4394~
ClTY STA?F ZIP CQLE P.Fc~A CQDEIP!iOPlE !'1AME Gr ASSISTRNT'REA5UkER, if R.N~' w~~
C~~ertEnQ CA 95414 4Q$.~57.49~s
STRE[T A~DRESS
.!AfCING Ri~DRESS (IF 6iFFcnENT;
i,+Tl' SThTE Z.lP COPE AR~A C°JDEIRMpNE
vp710NA1: FAX i E-MAI: ADDRE&S
NAME ANp POSiTiON OF 4TFiER PR1NClR4L tIFFlCE.R(S), !F ,4PPLICABL~
C~UhiTY C7F pUMICILE COUNTY WHrP.E ~JM1~IT7EE IS RC?IVE ;f DIFFEP.F.M'
THAN CUUNTV OF pOMlClI F - ~
M~I:iNG ADDRESS
Sania Clara ~ _
CITY SFATE ZiP CQDE ARFA C~DEtPHC?Nc
Atfach adrii~onal ir!farr.aUnn cm apWoDnately?abeleci cnntinuatian sneets.
Verif cation
! have used ail reasonabie diligence in prtpari~g this s4atement a~d to tne best of my knowCedge the :nform~ts~;n c-anta~ned herein is true and complete 1 ceRify under penalty of
perjury ur.der the laws af ths ~ta4e of Caiifornoa ihai the foregoing ~s true and correcl.
08/07'!07
Cxe~ated an By `
A GNATUPE R~FR O.R A$$ISTAMT TRfA6i}kEk
Executed an 081U7/G7 ~ `
pATF ~ g1ANA'iURE t CON ROLLli~1G QfFICEHOL7ER GAND![?!AF OR STPSE MEASURE FRqPONENT
On ~ATc ~ ~ SIGNAYURE Of CONTROL~fNG OFFICEHOLDER CRNDIOIVL OR 5TATf MFASURE PROPONENT
Exeuit~d o~ E~j _
OATE t U I,QN Ll IN O AN .U ^ A~ . SU E. PROp N N
FPPC Fcrm 44d (Janl01)
~'~Of Tnll C.na u..b.C..n- OR~~eCK_KODf'
Statement of Organizatian SfAFENiENT OF C7RGANIZATK)N
Recipier~t Committee ` ~ ' ~ 1
f '
lNSTRUCTlONS ON REVERSE
Page 2
COMMiTTFc' NFPAE I.U NUMBEP,
Re-eiect Mayor Patrick Kwok 1 Z37120
4. Type of Committee C~mplete the a~plicaDfe sections.
. . .
. List the name cf each controlling officeha~ider, candi~iate, ar state m~asure proponent. if candidate ar officehoidei cantrolfed, aEsa list the elect~ve office sought or h~lcl, and
distnct number, +f any, and !he year of the eiectio~.
• List the pol!tir_~I ~arty with whivn each o~cehofder or candRdaEe i~ affiliat~d a check "non-pa~
tisan."
•!fi this committee ~cts jaintty with another cantrolied cammitte$. i~st ihe n~me snd ident~fi:.atian number af ,he cthe: controtEed cammittee.
E!.ECTNE O~F1C~ SOUGHT pR HELG
NAME OF CANpI~IffEIOFFICEFiOLDER/STATE MEASURE FROPONENT (IN~IIiL~E DIS?RlCT tVUARBERlF A?PLlCABLE) VFAR OF ELECriON PAP TY
Patrick S. Kwok ~ Noe~-?artsan
~ Cupertino City C:ouncil ~ 2005
~ ~ ~ Non-Partisar~ ~
~ E _ - _ '
• List the financiai instit:ation wtiere th~ carnpaic~n bank accbunt ~s ~ocated (controlled "cand~~ate election" comm~ttees onty}
NA.ME r3f FiNANCiALINSYITUTION AREACODElPHO!~E E~ANK AC~QUNT N~~MSER ~
'Nachington Mutuaf E 1.80U.788.70Q0 ?852194364 ~
_...__._~.I..__ _
ADDRESS G~~"~ STA?E ZtP CC~QF.
2Q573 Stevens Creek Blwd Guperti~o CA 9~014
~ . , Primar,ly farmed to suppoR or oppose speci~c candidates ne measures in s si;~gle u~lectian. List belaw:
CANpID3~TE(S) p~fICE S~U~HT OR HELD ~JR MER,SUR[iS) JuR~SDlC;TiON
CANDIRATE(S) NAARE OR MEFSURE(S? fUiL ?ITLE (tNCLUDE BRl_LQT N~. OR LETTERj (4NC~UDfi DtSTR4C T NQ CITY OR COUNTY AS APPLiC?.BLEj CHE!,'K ONE
- ~ 3UPPORT ORPOSE
- ' 5UPPORT ppPqg~
FPPC Fom? 410 (,lan!0'! )
FPPG TQli-Free Helpfine: 866fASK-~PPG