410 Statement of Organization - Initial Not Yet Qualified Stamped by SOS noting ID numberStatement of Organization
Recipient Committee
15--70`590
Statement Type ® initial
❑ Amendment
Notyet quallfied ® or List I.D. number:
Date qualified as Committee Date qualified as committee
(If appfica!:W
I. Committee Information
NAME OF COMMITTEE
❑ Termination —See Part 5 f
List I.D. number: In
VAIDHYANATHAN FOR CUPERTINO CITY COUNCIL 2014
STREET ADD RESS(ND P.O. BOX)
NAME OF ASSISTANT TREASURER, IF ANY --
CAROLYN KRIZEK- MAHONEY
STREET ADDRESS (NO P.D. BOX)
NAME OF PRINCIPAL OFFICER {5)
STREET ADDRESS (NO PC. BOX)
CITY STATE ZIP CODE AREA CODE /PHONE
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 08/21/2014 By k��. �� 11%
DATE SIGNATURE OF TREASURER OR ASSISTANT TREASUR
Executed on 08/21/2014 By V �t
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
DATE
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (Dec /2012)
FP PC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA
Recipient Committee ; L i 4
INSTRUCTIONS ON REVERSE
Page 2
COMM €TTEE NAME
I.D. NUMBER
VAIDHYANATHAN FOR CUPERTINO CITY COUNCIL 2014
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODEfPHONE BANK ACCOUNT NUMBER
WELLS FARGO BANK (
ADDRESS rITY STATE ?IP CO DE
4. Type o9' Committee Complete the applicable sections.
II I
• List the name of each controlling officeho €der, 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."
• 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
SAVITA VAIDHYANATHAN
CUPERTINO CITY COUNCIL
2014
Nonpartisan
SUM
❑ Nonpartisan
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE(Si FULL TITLE (INCLUDE BALLOT NO. OR LETTER)
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MFASURE(SI JURISDICTION
IMIrI I IhC --I-T ni iTV nI r...1
FPPC Form 410 (Dec /20121
FPPC Advice: advice @fppc.ca.gov ($661275 -37721
www.fppc.ca.gov
. -.. _- _..___•
LHECA.7NE
SUPPORT
❑
OPPOSE
❑l
SUM
OM
FPPC Form 410 (Dec /20121
FPPC Advice: advice @fppc.ca.gov ($661275 -37721
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
VAIDHYANATHAN FOR CUPERTINO CITY COUNCIL 2014
4. Type of Committee ` (Continued)
Purpose General Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
Sponsored Committee List additional sponsors on an attachment.
GROUP OR AFFILIATION OF SPONSOR
1-- 1u -I... CITY STATE ZIP CODE
Page 3
LD. NUMBER
Small Contributor ,
Date qualified
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, ioans 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 (Dec /2012)
FPPC Advice: advice @fppc.ca.gov (666/275 -3772)
www.fppc.ca.gov