410 Amendment
Statement Type
o Initial
Not yet qualified 0 or
~ Amendment.
List 1.0. number:
o Termination - See Part 5
List 1.0. number:
Statement of Organization
Recipient Committee
Type or print In Ink
---1-----1_
Date qualified as committee
# 1257379
~~~
Date qualified as committee
(If applicable)
#
-----1-----1_
Date of Tennination
2. Treasurer and Other Principal Officers
NAME OF TREASURER
Lucy Lu
STREET ADDRESS
10720 Orline Ct
1. Committee Information
NAME OF COMM ITTEE
Re-Elect Kris Wang for City Council
STREET ADDRESS (NO P.O. BOX)
7645 Dumas Drive
CITY
STATE
ZIP CODE
AREA CODE/PHONE
CITY
Cupertino
NAME OF ASSISTANT TREASURER. IF ANY
STATE
CA
ZIP CODE
95014
AREA CODEIPHONE
408-255-2275
Cupertino
MAILING ADDRESS (IF DIFFERENT)
CA
95014
408-257-7516
STREET ADDRESS
CITY
STATE
ZIP CODE
AREA CODEIPHONE
OPTIONAL: FAX I E-MAIL ADDRESS
NAME AND POSITION OF OTHER PRINCIPAL OFFICER(S), IF APPLICABLE
COUNTY OF DOMICILE
COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT
THAN COUNTY OF DOMICILE
MAILING ADDRESS
Santa Clara
CITY
STATE
ZIP CODE
AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
3. Verification
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.
perjury under the laws of he State of Califomia that the foregoing is true and correct.
;:, \ .1) .) .~, ,',
Executed on ,J-..... ~ By
AJE
r,,')
DATE'
I certify under penalty of
Executed on
By
':"
, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
DATE
By
SIGNATURE OF CONTROlliNG OFFICE OLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT
DATE
FPPC Form 410 (January/05)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
Statement of Organization
Recipient Committee
STATEMENT OF ORGANIZATION
INSTRUCTIONS ON REVERSE
CALIFORNIA 410
FORM
I.D. NUMBER
f ~\:I $"7 9
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 "non-partisan:
. 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
2001 ~/ D Non-Partisan
Kris Wang City Council, City of Cupertino D
'- D Non-Partisan
. List the financial institution where the campaign bank account is located (controlled "candidate election" committees only)
NAME OF FINANCIAL INSTITUTION
AREA CODE/PHONE
BANK ACCOUNT NUMBER
Wells Fargo
ADDRESS
408-863-6100
8327019868
CITY
STATE
ZIP CODE
10260 S. De Anza Blvs
Cupertino
CA
95014
Primarily Formed Committee
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
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
I '"~,~ I ~-
SUPPORT OPPOSE
FPPC Form 410 (January/OS)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
Statement of Organization
Recipient Committee
STATEMENT OF ORGANIZATION
INSTRUCTIONS ON REVERSE
CALIFORNIA 410
FORM
COMMITTEE NAME
Re-Elect Kris Wang for City Council
4. Type of Committee (Continued)
I.D. NUMBER
1257379
General Purpose Committee
Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
~ CITY Committee 0 COUNTY Committee 0 STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
Re-Elect Kris Wang for City Council
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
Small Contributor Committee
o ---1-----1_ Check box and provide the date this committee qualified as a small contributor committee. If the committee qualified as a
Date qualified small contributor committee on January 1, 2001, enter 1/1/01.
5. Term ination Requirements By signing the verification, the treasurer, assistanttreasurer andlor candidate, officeholder, or proponent 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.
FPPC Form 410 (January/05)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)