410 Statement of Organization Recipient Committee - Initial Qualifed Statement of Organization
Recipient Committee •
Dale CALIFORNIA A
N'. CEtVED FORM 4� O
Statement Type ❑x Initial ElAmendment ❑ Termination–See Parts ForOfficial Use Only
Not yet qualified') or List I.D.number. List I.D.number:
MAY 16 2016
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L13� 110 ____i___I —1—JCUPERTINO CITYCLERK •
Date qualified as committee Date qualified as committee Date of Termination
Ql appnode)
1. Committee Information 2. Treasurer and Other Principal Officers
NAME OF COMMITTEE NAME OF TREASURER
Friends of Barry Chang Against the Recall Rita Copeland
SWEET ADDRESS(NO PO.BOX) STREET ADDRESS(NO P.O-BOX)
CftY STATE ZIP CODE AREACODEIPHONE CITY STATE ZIP CODE AREA CODE/PHONE
MAILING ADDRESS(IF DIFFERENT) NAME OF ASSISTANTTREASURER,IF ANY
FAX/E-MAIL ADDRESS STREET ADDRESS(NO P.O.BOX)
-
COUNTYOFDOMICILE 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 OF CONTROLLING OFFICEHOLDER.CANDIDATE.OR STATE MEASURE PROPONENT
Executed on BY
DATE SIGNATURE OF CO TROLDNG OFFICEHOLDER.CANDIDATE.OR STATE MEASURE PROPONENT
FPPC Form 410(Jan/2016)
www.neifile.com FPPC Advice:advice@fppc.ca.gov(8661275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee CALIFORNIA 41 0
FORM
INSTRUCTIONS ON REVERSE
Page 2 of 3
•
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.
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"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 CANDID/WE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY
City Council Member: City of Cupertino Q Nonpartisan
Barry Chang 2014
❑ Nonpartisan
Priniarlly 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 SOUGHTOR HELD OR MEASURE(S)JURISDICTION
(INCLUDE DISTRICT NO.,CIN OR COUNTY,AS APPLICABLE) CHECK ONE
SUPPORT OPPOSE
Recall Barry Chang (Pending) City of Cupertino
SUPPORT OPPOSE
FPPC Form 410(Jan/2016)
www.nettile.com FPPC Advice:advice@fppc.ca.gov(866/2753772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee CALIFORNIA A +� 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 ❑ COUNTYCommittee 0 STATECommittee
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 ❑ ��
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.
FPPC Form 410(Jan/2016)
www.netfile.com FPPC Advice:advice@fppc.ca.gov(866/276-3772)
www.fppc.ca.gov