410 Statement of Organization Recipient Committee – Initial QualifiedStatement of Organization
Recipient Committee
Statement Type 0 Initial fl Amendment Termination —See Part
Q Not yet: qualfied
or
0 Dgte qualified as committee7 12 2018
bate qualified as pommi4ee Date of terrninalUon
(if
NAME OP COMMITTEE
Mahoney for Council -201$
STREETADDRESS MOVE. BOZ
CITY 'STATE ZIP CODE- A'REAC 1)F1PHONE
MAIUKADOAESS IIF DIFFERENT)
E -MAI L AOaAES5 (ROW 1119D)1 FAX (DPV0;AQ
Santa Clara
Clara County
Attach additional inrfarmation .ars appropriately labeled continuotfon sheets,
penalty of perjury under the laws of the S
s
Executed ort By
Executed on �' 1 . / i. By
DATE
Fxecuted on
pate Stamp
JUL 16 ypig
Carolyn Krize0ahaney
STREET ADDRESS (NO Rd. BOX)
Ci�`1' STATE <ipCaEke ARBACpDE/P b E
NAME OFASSI5TAr4TSRwuRER;'tFA(qY
STREET AD KESS#NOP...X)
CITY - - - 5?A7t: - ww
v CODE AREAMDE/P N
w.,
NAME OF pRlNCIPAL OFfN%EA(5l
STREET AbbRESS (NO P.P. 9691
C!1'1' STATE ' W CODE AR A CQDE/PWR
OV.,
DATE 51GNATURE OP GONTROL..ING OFFICEHOLDER. CANGIDAiE, O� STATE MEASURE PROP.01M
Executed On By
DATE SIGNATURE OP WNTROLUNG OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
OPC W10 416 (. Nbraary/90101
FPPC Mvice: advice@fp?Ipc.ca.Vv (166/975-3772)
WWw fPPC.Ca$ gw
Statement of Organization CALIFORNIA'
Recipient Committee FORM
INSTRUCTIONS ON REVERSE Page 2
COMMITTEE NAME I.D. NUMBER
Orrin Mahoney for Council -2018
+ All committees must list the financial insti#ution where the campaign bank account is located,
NAME OF FINANCIAL INSTITUTION AREAcoPE/PHONE BANK ACCOUNT NUMBER
Wells Fargo
ADDRESS
CITY
srA?E ZIP CODE
4 TYpeof CorKmlitte CoCnpaete tlte'applIcable sect♦sns
d 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:' Siatng "No party preference" is acceptable.
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 PARTY
NAME OF CANDIDATE/01'FicEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECKONE
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) FULLtITLE (INCLUDE BALLOT NO. OR LETTER)
LG A DCPA1 L CFATL' ADtr&t W w rQn1dT nr T14F flCClf Fi4l7E nFR'S NAME.
CANDIDATES) OFFICE SOUGHT OR HELD OR MEASURES) JURISDICTION
(INCLUDE DISTRICT NO.. CITY OR COUNTY, AS APPLICABLE)
04PCI( ONE
SUPPORT
Nonpartisan
Partisan
(list political parry below)
Orrin Mahoney
Cupertino City CotAncil
2018
Nonpartisan
Partisan
(list political party below)
El
1:1
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) FULLtITLE (INCLUDE BALLOT NO. OR LETTER)
LG A DCPA1 L CFATL' ADtr&t W w rQn1dT nr T14F flCClf Fi4l7E nFR'S NAME.
CANDIDATES) OFFICE SOUGHT OR HELD OR MEASURES) JURISDICTION
(INCLUDE DISTRICT NO.. CITY OR COUNTY, AS APPLICABLE)
04PCI( ONE
FPPC Form 410(February/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
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
Recipient commifitee
INSTRUCTIONS ON REVERSE
pap 4
COMMITTEE NAME I.D. NUMBER
Orrin Mahoney,for Counc11-2018
4 TY00 0f Cahimittee. (coatingedl
• •I Not formed to support or oppose specific candidates or Measures in a single ejection. Check only one box. -
O City Co mitittee 0 COUNTY Committed 0 STATE Committeet] P6110cal Parts►/Centrai Committee
PROVIDE BRIEF xscRIPTION OF ACTIVITY
NAME OF SPONS08
STREETADDRESS
List additional sponsors on an attachment.
5TREET
Date glJalified
CITY
INDUSTRY GROUP 09 AFFI LIATION OF SPONSOR
ZIP CODE AREA
By si$nln.g the verfrication, 6e treasurer assistant treasurer'and r candidate, officeholder
":0ropofient certify that all �# the follvwin� cOlTditlon5 gave been mit
• This committee has ceased to receive cohtributiops and make expenditgres;
r This committee does snot anticipate ireceivingcontributions 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 ail reportable transactions.
-- There are restrictions on the disposition of surplus campaign funds held by elected officer's who are leaving office and by defeated candidates. Refer'tq Government
Code Section 89519.
-- Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Governrhent Code Sections -89511- 89510, and are
subject to Elections Code Section 18680 and FPPC Regulation 1$521.5.
dear Pae PrintFPPC Frsrna asci (F�haary/20i 0)
FPPC Advlce, advice@fppc.ca<guv (066/27$-377A")
www.fppfi.ca.ggv