410 Statement of Organization Recipient Committee – Initial Stamped by SOS ��
Statement of Organization � � Da[eStamp , _
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Recipient Committee ��� i� !
Statement T 0 For Official Use Only I i
Yp �Initial ❑ Amendment ❑ Termination—See Part 5 p �j +i�s g:� � i
L i s t I.D.n u m b e r: L i s t I.D,n u m b e r: R����e�� �"�� � 0 r� !� I
N�t yet�ualifie� ❑ •r in th:office of the Secretary I I
# # of the State of CaUfomia 0 C T - 5 2 U 16 �L�
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09 �15 �2016 , � �_, SEP 19 201� CUPERTINO CITY CL RK
Date qualified as committee Date qualified as committee Date of Termination
. (If applicable�
�::�Comm�ttee lnformat�on�`�: �= .;�,:'��� ���;����,�. �� ��,-����y_-_; --��,;����2��1"reas�urer an'�cl�Ot}�ie�Psr�ncipal��,fFicers�,�,, .~��r.
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YNAME OF COMMITTEE LL NAME OF TREASURER��
Kris wang for City Council 2016 Anqela Tsai
STREETADDftE55(NO P.O.BOX)
STREETADDRESS(NOP.O.BOX) CITY STATE ZIPCODE AftEACODE/PHONE
CITY STATE ZIPCODE AREACODE/PHONE NAMEOFASSISTANTTREASURER,IFANY
Cpertino CA 95014 (
MAILING ADDRE55(IF DIFFERENT) STREET A�ORESS(NO P.O.BOX)
FAX/E-MAILAD�RESS CITY STATE 21PCODE AREACODE/PHONE
COUNTY OF DOMICILE I IURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFfICEft(5)
STREET ADDRE55(NO P.O.BOX) -
CIT/ STATE ZIPCODE AREACODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
. .
3: Verificatton�_�____ ��a �`�-�'�e'� �, � xyy �K - - _ --z �.���
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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 ' e ia that the foregoing is true and correct.
Executed on ���S'�� By
DATE �
CANDIDATE,OR STATE MEASURE PROPONENT �
Executed on By
DATE SIGNATURE OF CONTROLLING OfFICEHOIDER,CANDIOATE,OR STATE MEASURE PROPONENT
FPPC Form 410(Jan/2016)
FPPC Advice:advice@fppc.ta.gov(866/275-3772)
www.fppc.ca.gov
. � - . I �
Statement of Organization �
Recipient Committee • "
INSTRUCTIONS ON REVERSE
Page 2
l
COMMITTEE NAME I.D.NUMBER
Kris wang for City Council 2016
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIALINSTITUTION � AREACODE/PHONE BANKACCOUNTNUMBER
Wells Fargo Bank I(800)742-4932
ADDftE55 QTY STATE ZIP CODE , �
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4.�y e af'�r�r�ittee��Com�fe€e��e-,�-a�,C�a���r�s'�'���:-: �.�',�,;��. � ��`" ;
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l�•lif�'i J�11�1%��Ul��lui}�tx�
• 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 PARTY
� Nonpartisan
Kris Wang Cupertin� City Council 2016 ,
❑ Nonpartisan
■y,7„@n,ri.�,;.��'�,•r1.,,;,,,,��t;�� Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(5)NAME OR MEASURE(S)FULLTITLE(INCLUDE BALLOT NO.OR LETTER) CANDIDATE(5)OFFICE SOUGHT OR HELD OR MEASUREIS)JURISDICTION
(INCLUDE DISTRICT NO.,CITY OR COUNTY,AS APPLICABLE) cHECK oNe
� SUPPOftT OPPOSE
❑ ❑
SUPPORT OPPOSE
❑ ❑
FPPC Form 410(Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization � • - � t
Recipient Committee • - �
INSTRUCTION$ON REVERSE
Page 3
� COMMITTEENAME - I.D.NUMBER
Kris wang for City Council 2016
t :: n. .>�/��,t f'�,ry��"royn�7�{..,'..."tY uJ !-":�"5 6 . (5.4..�1 T4 `-�'S ,, � 3' SY�.^�'. �,��3Y " _
4i`?TV�I e:V1.�r�lt��li�L�ee- 4,�.l.�Tlfltll/� +..� _ V ,�r� .� 5j yp`�'-r s•'Aks! '�.� ".'�,a- 1 .iY�y & .',�'-'�`�"�'yiv T1 :����'Yay� +`r�ia�s� `��` ,ca�Aaa�-ieaJ '�'
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���'�1a1%le�:i"i;�%�1'•ii=�p%)%%1,��;i���;,'y-`� Not formed to support or oppose specific candidates or measures in a single election. Check only one 6ox:
❑ CITY Committee �J COUNTY Committee� STATE Committee
PROVI�E BRIEF DESCRIPTION OF ACTIVITY
��,��i�1.�:f'2�%�lt%1��'i;'llt;«� List additional sponsors on an attachment.
NAME OF SPONSOft IINDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET AOOftESS NO.AND STREET CITY STATE Z�P CODE
F.^-.
�ii'�;illk`%I�ii;ih'�r��i�{���K;lii��i`}����:�1� ❑
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Date quallfled
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�S.-Tet"llllt'ic'iL10[l.wReC�U1Ce[T72t1'CS 6:=�gning"[he� rFfiSaboptk�e�teasu r�'° tstanY,tteasurerar�dJoYrapdidd� �IinfdeYAt`peqppnc�C: o o � g�q:ds�tatis� ave-6eerl'�e ,�� -
�_�.�,s..:�:�ra�,._,_..._>_.-. >.....__�.,_� ��ti��,s,�v a-.,�u,.���. �m_��xa�..�e.�._.-�.-yv�..�...- «« ��-'�..�.r�,�.� ��.::.s.as,m;...m.sm�..�R_sm.----��.z,�s.�*�a-,:.m.�__sy.��'�4��-.r.�. :. .:.-a
• 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�r 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)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov