410 Statement of Organization Recipient Committee - Amendment 2-1-19 Statement of Organization � m � . � _ . '
I�ecipient Committee �
• -
Statemenf Type ��nitial � Amendment ❑ Termination—See nart r ForOfficialUseOnly
Q Not yet qualifred ��� � 2��
or
Q Date qualified as committee lo � zi �aoza � �� � ���Ts�� �������
• Date qualified as committee Date of termination �6
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1: Committee Information �•D. Number 14i2139 2. Treasurer and Other Principal Officers
(if applicable)
NAME OF COMMITTEE � ' � NAME OF TREASURER � '
Cupertino Residents for Local Ethical Government Opposing Chao & Willey for Michael Malik
Clt.}� COUriC11 �2018 �
COUN7YOFDOMIQLE � 1URISDICTIONWHERECOMMITTEEISACTIVE NAMEOFPRINCIPALOFPICER(5)
Santa Clara County Cupertino Oscar Hur
� STREET ADDRESS(NO P.O.BOX) .
3. Verification
I have used all reasonable diligence in preparing
Executed on gy
DATE � SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
Executed an gy
� DA7E SIGNATURE OF CONTftOLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT
Executed on gy
DATE SIGNATURE Of CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASU�B R�20PONENT .
� FPPC Form 410(February/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization . � _ ,
Recipient Committee � _ � S
INSTRUCTIONS ON REVERSE
Page 2 page 2 of 3
COMMITTEE NAME �
. I.D.NUMBER
Cupertino Residents for Local Ethical Government Opposing Chao & Willey for City Council 2018 1412139
� All committees must list the financial institution where the campaign bank account is located.
� NAME OF FINANCIALINSTITUTION � . � AREACODE/PHONE BANKACCOUNTNUMBER
Bank of San Francisco (
ADDRE55 � . �
4.Type of Committee Complete the applicable sections.
• 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:` Stating"No party preference"is acceptable.
o 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 YEAR OF pAR7y
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IFP.PPLICABLE) ELECTION � cHECKONE
Nonpartisan Partisan (list political party tiefow)
Nonpartisan Partisan (list political party below)
-- Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S)NAME OR MEASURE(S}PULL TITLE(INCLUDE BALLOT NO.OR LETTER) CRNDIDATE(S)OfFICE SOUGHT OR HELD OR MEASURE(S)JURISDlCTION
. � IFA RECALL,STATE"RECALC'IN FRONT OFTHE OFFiCEHOLDER'S NAME. (INCLUDE DISTRICT NO.,CiTY OR COUNTY,AS APPLICABLE) CHECKONE �
� � SUPPORT OPPOSE
� SUPPORT OPPOSE
FPPC Form 410(February/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
�tatement of Organization , � _ ,
�ecipient Committee � _ � �
INSTRUCTIONS ON REVERSE
Page 3 page 3 of 3
COMMITTEE NAME
I.�.NUMBER
Cupertino Residents for Local Ethical Government Opposing Chao & willey for City Council 2018 1412139
�4.Type of Committee {Continued)
Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
x� CITY Committee ❑ COUNTY Coimmittee❑ STATE Committee❑ Political Party/Central Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY � � ._ .
To support and oppose candidates and measures of interest to residents of Cupertino who are comitted to Ethical government
� � - List additional sponsors on an attachment.
NAME OFSPONSOR . � INDUSTRY 6ROUP OR AFEILIATION OF SPONSOR � �
. STREETADDRESS � NO.ANDSTREET . CITY STATE ZIPCODE AREACODE/PHONE
� � �
Date qualified
5.Terminafion Requirements Bysigningtheverification,thetreasurer,assistanttreasurerand/orcandidate,officeholder,orproponentcertifythatallofthefollowingconditionshavebeenmet:
• 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 Politica) Reform Act disclosing all reportable transactions.
-- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving ofEice and by defeated candidates. Refer to Government
Code Section 89519.
-- Leftover funds of ballot measure committees may be us�a 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(February/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov