410 Statement of Organization Recipient Committee – Initial Not Yet Qualified Signed by Treasurer Statement of Organization
Recipient Committee Date Stamp rnLIFORNIA
' , ,,_2 0)� It Ii W 5 FORM 410
Statement Type Qx Initial 0 Amendment 0 Termination—See Part 5i _If For Official Use Only
Not yet qualified 0 or List I.D.number: List I.D.number. al
# # :fin — 2 2016
Date quafied as committee Date qualified as committee Date of Termination CUPS 1T I N O CITY CLERK
(II appli atle)
1. Committee Information 2. Treasurer and Other Principal Officers
NAME OF COMMITTEE NAME OF TREASURER
Friends of Barry Chang Against the Recall Rita Copeland
STREET ADDRESS (NO P.O.BOX) STREET ADDRESS(NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE
MAILING ADDRESS(IF DIFFERENT) NAME OF ASSISTANT TREASURER,IF ANY
FAX/E-MAIL ADDRESS STREET ADDRESS(NO P.O.BOX)
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE CITY STATE ZIP CODE AREA CODE/PHONE
Santa Clara Cupertino
NAME OF PRINCIPAL OFFICER(S)
Attach additional information on appropriately labeled continuation sheets. STREET ADDRESS(NO P.O.BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
3. Verification
I have used all reasonable diligence in preparing
CANDIDATE,OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE I- ONTROLLING OFFICEHOLDER,CANDIDATE.OR STATE MEASURE PROPONENT
Executed on BY
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER.CANDIDATE,OR STATE MEASURE PROPONENT
www.netfile.com FPPC Form 410(Jan/2016)
FPPC Advice:advice@fppc_ca.gov(866/275-3772)
www.fppc.ca.gov
•
Statement of Organization
Recipient Committee CALIFORNIA 410
FORM
INSTRUCTIONS ON REVERSE
Page 2 of 1
COMMITTEE NAME I D.NUMBER
Friends of Barry Chang Against the Recall
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
Community 1st Bank (
ADDRESS CITY STATE ZIP CODE
4.Type of Committee Complete the applicable sections.
Cotntroiiid 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"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 PAR TY
Mayor Nonpartisan
Barry Chang
❑ Nonpartisan
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
Recall Barry Chang Mayor, City of Cupertino X
SUPPORT OPPOSE
www.net�le.com FPPC Form 410(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(8661275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee CALIFORNIA it 1 O
FORM �F
INSTRUCTIONS ON REVERSE
Page 3 of 3
COMMITTEE NAME
I.D.NUMBER
Friends of Barry Chang Against the Recall
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 i] STATECommittee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
Sponsored Committee List additional sponsors on an attachmenL
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO.AND STREET CITY STATE ZIP CODE
Small Contributor Committee _1_ 1
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, 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.
-- 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.
www.netfile.com FPPC Form 410(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov