Loading...
410 Statement of Organization 06-30-2010 jtemient of Organization ;cipient Committee Type or print in ink _ 80- AM �1 :atement Type ❑ Initial ❑ Amendment © Termination — See Part 5 or official Use any Not yet qualified 171 or List I.D. number: List I.D. number: _ 2 2010 # 1320160 AUG V 06 1 30 / 2010 CUPERTINO CITY CLERK Date qualified as committee Date qualified as committee Date of Termination (if applicable) 1. Committee Information 2. Treasurer and other Principal Officers NAME OF COMMITTEE NAME OF TREASURER MAHESH NIHALANI FOR COUNCIL 2009 EDWARD L. GRANT, CPA STREET ADDRESS 19989 STEVENS CREEK BLVD STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODFJPHONE 7938 MCCLELLAN ROAD, #2 CUPERTINO CA 95014 408 -773 -1400 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY CUPERTINO CA 95014 408 - 343 -1211 STREET ADDRESS MAILING ADDRESS (IF DIFFERENT) CITY JTAi E ZIP CODE AREA COD&PHONE OPTIONAL: FAX/ E -MAIL ADDRESS NAME AND POSITION OF OTHER PRINCIPALOFFICER(S), IF APPLICABLE COUNTY OF DOMICILE COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT THAN COUNTY OF DOMICILE MAILING ADDRESS SANTA CLARA COUNTY 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. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on 712 ;�I J0 By DATE TURE OF TREASURER OR ASSISTANT TREASURER il Executed on 2d ( d By DATE SIGNATURE OF C G OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT 1 � By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (January/06 FPPC Tail -Free Heipline: 866 /ASK -FPPC (8661275 -377' Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee CALIFORNIA FORM 410 INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER MAHESH NIHALANI FOR COUNCIL 2009 1320160 4. Type of Committee Complete the applicable sections. • 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 Non- Partisan MAHESH NIHALANI CUPERTINO CITY COUNCIL 2009 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 BANK 408 - 863 -6100 8123969191 ADDRESS CITY STATE ZIP CODE 10260 S. DEANZA BLVD CUPERTINO CA 95014 L 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 SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 410 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee CALIFORNIA FORM 4100 INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D. NUMBER MAHESH NIHALANI FOR COUNCIL 2009 1320160 4. Type of Committee (Continued) • • Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee F] COUNTY Committee ❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY • • List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE 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. Termination Requirements By signing the verification, the treasurer, assistant treasurer and /or 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) Statement of Organization STATEM:H O F GANIZATION Recipient Committee Type or print in ink a s ^a TATE. D N ©N uw :n.,,.::::.IFIOvRNEIA FO 410 Statement Type ❑ Initial 1=1 Amendment © Termination — See Part 5 ' Ficial Use O Not yet qualified ❑ or List I.D. number: List I.D. number: X11 - 2 2010 ® # # 1320160 AV LU ° t t lte OR ° LE ta � D c C alif ornia __I� �_I 06 / 30 / 2010 CUPERTINO CITY CL:RK AU Date qualified as committee Date qualified as committee Date of Termination 2 o 10 (If applicable) 1. Committee Information 2. Treasurer and Other Principal Officers Se et ary 6UWEN NAME OF COMMITTEE NAME OF TREASURER of Or ate MAHESH NIHALANI FOR COUNCIL 2009 EDWARD L. GRANT, CPA STREET ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE CITY STATE ZIP CODE AREA CODE /PHONE NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS (IF DIFFERENT) STREET ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / 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 COUNTY 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. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on '7(.2..".517/ By ' DATE - - L h RE OF TREASURER OR ASSISTANT TREASURER Executed on I I By '', DATE SIGNATURE OF CO 4 7: G OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT 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 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee CALIFORNIA 410 FORM INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER MAHESH NIHALANI FOR COUNCIL 2009 1320160 4. Type of Committee Complete the applicable sections. 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. ELECTIVE OFFICE SOUGHT OR HELD NAME OF CANDIDATE /OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY IR Non - Partisan MAHESH NIHALANI CUPERTINO CITY COUNCIL 2009 Non - Partisan I I l • 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 BANK 8123969191 ADDRESS CITY STATE ZIP CODE 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 SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 410 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Statement of Organization STATEMENT OF ORGANIZATION Recipient Committee CALIFORNIA 41 0 FORM INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I.D. NUMBER MAHESH NIHALANI FOR COUNCIL 2009 1320160 4. Type of Committee (Continued) 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 ❑ 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 Small Contributor Committee 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. Termination Requirements By signing the verification, the treasurer, assistant treasurer and /or 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)