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410 Statement of Organization Recipient Committee - Initial Qualified Stamped by SOS Ac tiy • HOC Statement of Organization / zj�f/7-7� Recipient Committee • / Dale Stamp ! CALIFORNIA Aln RECE AND FILED, �t1 Statement Type Initial ❑ Amendment El Termination–See Part 6 In lire otfilce EDB Secretary of sum;ttar fiC Only . Not yetqualifiedl� or List I.D.number. List I.D.number: of the State d Cat•Ito/B # # Mp1 13 2016 MAY 2 7 2016 15_-_f_W_ c o —J—_I -J—J CUPERTINO CITY C ERK Date qualified as committee Date qualified as committee Date of Termination (II appllcaNe) 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 RO.BOX) STREET ADDRESS(NO P.O_BOX) CRY STATE ZIP CODE AREACODE/PHONE CRY 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) COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE CITY SURE ZIP CODE AREA CODE/PHONE Santa Clara Cupertino NAME OF PRINCIPAL OFFICERS) • 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 CONTROLUNG OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT Executed on BY DATE SIGNATURE OF CONTROLLING OFFICEHOLDER.CANDIDATE,OR STATE MEASURE PROPONENT _ FPPC Form 410(Jan/2016) www.rretfrle.com 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 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 let 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 CANDIEMTE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY City Council Member: City of Cupertino ® Nonpartisan Barry Chang 2014 0 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(5)JURISDICTION (INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) CHECK ONE SUPPORT OPPOSE Recall Barry Chang (Pending) City of Cupertino X SUPPORT OPPOSE FPPC Form 410(Jan/2016) www.netfile.com FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee CALIFORNIA 41 0 FORM 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 ❑COUNTY Committee ❑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 ❑ �_J Date qualified 5.Termination Requirements By signing the verification,the treasurer,assistanttreasurerand/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(6661275-3772) www.fppc.ca.gov