410 Statement of Organization Recipient Committee - Initial Not Yet Qualified Stamped by SOS �ejecteci: �
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❑Initial ❑ Amendment ❑ Termination—See Part 5 ��������j����� �i r-- ' S �i i
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I.D. Number z �� �p . 6 ::�� �,� i . �, �, �
1. Committee Information 2. Treasurer and Other Principal O{ficers
(f�aPPlicabieJ
� NAME OF COMMITTEE � � � � NAME OF TREASUREft. � . . �
Gary E. Jones
Cupertino Residents for Loca1 Ethical Government
- . � - �
Na.ncy L Warren � � . . � -
MAILINGADDRESS(IFDIFFERENT) � � STREETADDRESS{NOP.O.BOX� �
� COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE 15 ACTIVE � NAME OF PRINCIPAL OFFICER(S) �
Santa Clara County Cupertino Oscar Hur
� � STREE7 ADDRESS{NO P.O.B�X) . �
3. Veri 'cation
I have used all reasonable diligence in
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Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE NIEASURE PROPONENT
Executed on gy
OATE � SIGt�ATURE OF CONTROILING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT �
FPPC Form 410(February/201$)
FPPE Advice:advice@fppt.ca.gov(866J2753772)
www.fppc.ca.gov
Staternent of Organization
Rec�=pient Committee • - � , �
. -
INSTRUCTIONS ON REVERSE
_ � - - � � � Page 2 of 4
COMMITTEE NAME I.D.NUMBER
Cupertino Residents for Local Ethical Goverriment
2a. Additional Officers/Assistant Treasurers
NAME NAME
Michael Malik
MAILING ADDRESS MAILING ADDRESS
NAME NAME
MAILING ADDRESS MAILWG ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE
NAME NAME
MAILING ADDRESS MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE
NAME NAME
MAILING ADDRESS MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODElPHONE
FPPC Form 410(february/2018)
www.ne�le.com FPPCAdvice:advice@fppc.ca.gov(866/275-3772)
wr^+W-fPPc.ca.gov
Sta�ement of Organization � • - , 1
Recipient Committee • - �
INSTRUCTIONS ON REVERSE . � � �
Page 2 page 3 of 4
COMMITTEE NAME � . I.D.NUMBER
Cupertino Residents for Local Ethical Government
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIALINSTITUTION � � AREACODE/PHONE BANKACCOUNTNUMBER
Bank of San Francisco ( 704019232
ADDRE55 CITY STATE ZIP CODE � .
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.
• If this committee acts jointly with another controlled committee,list the name and identification number of the other cor�trolfed committee.
ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY
NAME OP CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT. (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELELTION CHECKONE � .
Nonpartisan Partisan (list political party below)
Nonpartisan Partisan Qist political party below)
� � • •� � -- Primarily formed to support or oppose specific candidates or measures in a single election. List 6elow:
CANDIDATE(S)NAME OR MEASURE(S)FULLTITLE(INCLUDE BALLOT NO.OR LETTER) CANDIDATElS)OFFICE SOUGHT OR HELD OR MEASURE(5)JURISDICTION
fF A RECALL,STATE"RECALL"IN FRONT OF THE OFFICEHOLDER'S NAME � UNCLUDE DISTRICT NO.,CITY OR COUNTI;AS APPLICABLE) cHECK oNE �
� . . SUPPORT OPPOSE
. � . � . SUPPORT OPPOSE
FPPC Form 410(February/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
Statement of Organization . s - . '
Recipient Committee • - �
INSTRUCTIONS ON REVERSE � � . �
Page 3 page 4 of 4
COMMI'ITEE NAMF I.D.NUMBER .
Cupertino Residents for Local Ethical Government
4.Type of Committee (Continuedj
�� • � Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
�CITY Committee ❑ COUNTY Committee❑ STATE Committee❑ Political Party/Central Committee
PROVIDE BRIEF DESCRIPTION OPACTIVITY � �� � �
To support ethical and oppose unethical candidates for office in the City of Cupertino
�� � •� � List additional sponsors on an attachment.
NAMEOFSPONSOR � INDUS'1'RYGROUPORAFFILIATIONOFSPONSOR - .
STREETAD�RESS NO.ANDSTREET � � CITY . � STATE ZIPCODE � AREACODE/PHONE
r � i • � ❑ � . � � � .
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Date qualified � . �
5.Termination Requirements By s�gn��gtne�e��fi�ar�o�,the treasurer,assistant treasurer and/or candidate,officeholder,or proponent certifythat all ofthefollowing conditions have been met:
• This committee has ceased to receive contributions and make expenditu¢-es;
• 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.
-- Th2fe af2 feStflCtlOnS 0l1 the di5position 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(February/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov